Dental Implant Outcomes in Osteoporotic and Osteopenic Women: A Systematic Review on Premenopausal Care

Abstract

To synthesize the available human clinical evidence on dental implant outcomes and preoperative risk assessment in women with osteoporosis or osteopenia, with particular attention to the applicability of the evidence to premenopausal care. The review protocol was prospectively registered in PROSPERO (CRD420261509680). PubMed/MEDLINE, Scopus and Web of Science were searched for primary human clinical studies evaluating osteoporosis, osteopenia, bone mineral density, menopausal status, bone turnover, or anti-osteoporotic treatment in relation to dental implant outcomes. Eligible observational studies were synthesized narratively because of clinical and methodological heterogeneity. Risk of bias was assessed using design-appropriate JBI critical appraisal tools and ROBINS-I when applicable. Eight primary human studies formed the principal clinical evidence base. Implant survival was generally high, but findings were heterogeneous for early or repeated implant failure, marginal bone loss, implant stability, local bone characteristics, and bone turnover. One retrospective study reported associations between osteopenia/osteoporosis and selected first, repeated, and early implant-failure outcomes. Osteoporosis and osteopenia should not be interpreted as uniform predictors of dental implant failure. The available evidence supports individualized assessment of systemic skeletal status, local bone characteristics, menopausal status, bone turnover, medication exposure, and conventional implant-related risk factors. Evidence remains insufficient to define a validated premenopausal osteoporosis-specific preoperative protocol.