Effects of bisphosphonates in orthodontic therapy:systematic review

Abstract

Background: Currently, the use of oral and systemic bisphosphonates, in the form of anti-osteoporosis medications or as a part of a chemotherapeutic regimen for several malignant diseases, is increasing dramatically in a large group of orthodontic patients. Animal studies have reported adverse dental effects from bisphosphonates, including decreased tooth movement, impaired bone healing, and osteonecrosis in the mandible and the maxilla. Objective: The objective of this paper was to analyze the effects of bisphosphonates on orthodontic therapy in humans. Strategy: The literature was systematically reviewed using PubMed, LILACS and OvidMedline up to December 31, 2011. Handsearching included several dental journals. Study selection: All RCTs, controlled trials and case reports-series about the effects of bisphosphonates on orthodontic therapy were analyzed and selected independently by two different researchers based on previously established inclusion and exclusion criteria. The main search terms were: bisphosphonates, orthodontic treatment and tooth movement. Results: The search strategy yielded 136 titles/abstracts: 134 from PubMed and 2 from LILIACS; no articles from OvidMedline, Chocrane Library and manual search. Eighty three records were screened, after removal of duplicates. After applying the inclusion/exclusion criteria, 135 papers were removed: 43 studies on animals, 4 French and Portuguese articles, 17 reviews and letters, 18 unrelated to orthodontic therapy or to the topic of this review. Conclusions: Further studies are required to assess possible adverse effects of bisphosphonate on orthodontic treatment in humans.