Dental implants in patients who have suffered from cancer
Requirements to be taken into accountIt is of recurrent use, in the field of oncology, the treatment with bisphosphonates for diseases such as tumor hypercalcemia, the prevention and treatment of events derived from bone metastasis and in the prevention of osteoporosis associated with breast cancer. However, this treatment reports a series of adverse side effects, including osteonecrosis of the jaws (ONJ), atypical fractures, musculoskeletal pain, and atrial fibrillation.
It has not been shown that the appearance of ONJ is caused by bisphosphonates, however, when the course of this treatment is paused, an improvement occurs. ONJ occurs when the jaws are under constant stress, resulting in microfractures, causing the bone to become brittle and unable to repair. The use of bisphosphonates usually develops ONJ between 4 months and 6 years after starting treatment, and it usually affects those areas in which surgery has been performed, frequently in the lower jaw and molar area. As a result, currently the recommendations focus on individualizing the prescription of this type of medication based on the number of fractures that the patient presents, in addition to taking dental hygiene measures and check-ups by a dentist.
Given these facts, before resorting to the placement of dental implants in patients who have suffered cancer, it is essential to review the patient's medical history in detail, taking into account all kinds of treatments that have been received and analyze the impact on the bone of the jaws. On the other hand, it will be necessary to exchange information with the oncologist who has treated the patient to confirm that there is no contraindication to implanting the patient. In this study it will be necessary to carry out a complete radiological analysis with low radiation so that it can be visualized in three dimensions and choose the ideal areas to place the implants.
In short, it is an essential requirement to study the clinical history of the patient who has suffered cancer to assess the status of the maxillofacial bone. As there is no evidence to show the level of risk that exists for developing osteonecrosis of the jaws, it will be necessary to assess bisphosphonate prescriptions to assess the risk of fractures. If this is your case, make an appointment with our specialist and we will advise you on the best solution.
Dr. María de la Sota