Do anabolics influence osseointegration?

Would anabolic drugs have any detrimental effects on osseointegration of dental implants?

Let's look at the case below:

The case in question consisted of a female patient, in her 30s, in perfect health, practically bodybuilding and who eventually (or constantly) made use of food supplementation and other substances. Finally, the patient had an upper premolar with longitudinal root fracture and we opted for extraction and immediate implantation.

Everything went perfectly. Uneventful surgery and implant locked with 45N. Four months later, at the time of reopening, the implant was not integrated. The professional removed the implant, reconditioned the bed and placed another implant from another manufacturer, locking 45N… Six months later the implant was not integrated either.

Identical postoperative, no infections, nothing out of the ordinary. What could be causing this? There are reports in the literature about the action of testosterone and other anabolic drugs on bone metabolism, being even used in the treatment of osteoporosis, but no relation with osteonecrosis or osseointegration of implants. And as observed at the time of reopening there were no signs of bone necrosis.

Is this then the insertion and locking torque of the implant? The professional reworked all the work, but this time he did not underweight (prepare the bed with a smaller diameter cutter than the implant for greater locking) and prepared the bed for the implant to its exact diameter. Installed a 4.1mm tapered implant and milled to the 4.1 drill. This time the lock was much smaller, only 23N, but within the acceptable primary stability parameters. It was scheduled and reopened after 8 months.

At the time of reopening the surprise - the implant was properly integrated into the bone and ready to be conditioned to receive the prosthesis.

So, with this report and other reports found on the Internet (I recommend the perioimplant group on Facebook) we can conclude that anabolic drugs influence the integration of implants or was it a coincidence?

We must investigate! Here is a suggestion for a medium- and long-term study!

By: Guilherme Muck.

Source: Vida de Dentista. Available at: https://vidadedentista.com.br/2015/08/odontoseccao-16-anabolizantes-influenciam-na-osteointegracao.html. Access on: 11/21/2019.