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Objectives: Comparison of the impact of bisphopshonates and of denosumab, 2 popular treatment therapies in osteoporosis, on oral implant osseointegration, based on scientific evidence. Material and Methods: The PubMed (Medline) database was searched for articles published up until April 1st, 2018. The search was used to compile evidence on the mechanisms of both types of drugs and their impact on oral implant osseointegration. To do so, mesh terms, keywords and filters were applied. Results: The searches resulted in 947 articles for bisphosphonate and 295 articles for denosumab respectively. After selection according to the eligibility criteria, 21 studies were included. 18 of these studies discussed the role of bisphosphonates in implant dentistry. To the authors’ knowledge, there is little evidence yet on the effect of denosumab on oral implant osseointegration. Conclusion: Reports providing information related to titanium implant osseointegration in patients taking denosumab is currently lacking. It is anticipated that this knowledge gap will be bridged in the near future, given the increasing use of the drug in the treatment of osteoporosis.
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Diabetes is a chronic, metabolic disease characterized by elevated levels of blood glucose, asso-ciated with premature mortality and morbidity. Lifestyle changes and/or bypass surgery increase quality of life. Recent studies have shown that skeletal fragility should also be considered among the complications associated with type 2 diabetes and following bypass surgery. Individ-uals with type 2 diabetes have increased fracture risk, despite normal to increased bone mineral density. The phenomenon of skeletal fragility in diabetes is not completely understood. In order to contribute to this lack in knowledge, the present study focused on the relationship between the microarchitecture of the bone structure and the parameters diet and age. The diet-induced obese diabetic mouse was used as animal model, in which a high fat diet was given for a period of 22 weeks. Micro-computed tomography analysis was performed to evaluate the micro-architecture of trabecular and cortical femur bone. A lower bone volume in a population sample of mice with diet-induced obesity and diabetic phenotype and of mice with bypass surgery, compared with young and age-matched controls, was found. In terms of cortical bone changes in response to high-fat diet and ageing, a decrease in the cortical bone volume was observed for both the diabetic obese and the bypass mice. Although this study is preclinical research per-formed in rodent animals, the observed overall significant catabolic changes in trabecular and cortical bone corroborate with the findings in human studies that diabetes and bypass surgery influence the bone architecture.
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