Pharmacology & Medications in Implantology Flashcards

Patients taking bisphosphonate medications (e.g., alendronate) present an elevated risk for which serious implant-related complication?

Answer: Medication-related osteonecrosis of the jaw (MRONJ)

Bisphosphonates inhibit osteoclast activity, which can impair bone remodeling and blood supply, increasing risk of osteonecrosis, especially after surgical trauma.

Which corticosteroid is sometimes prescribed pre-operatively before implant placement to reduce post-surgical edema?

Answer: Dexamethasone 4–8 mg single dose

A single pre-operative dose of dexamethasone 4–8 mg reduces post-surgical swelling and trismus without significantly suppressing the immune response.

Which hemostatic agent can be placed directly into the implant socket to aid in bleeding control during implant placement?

Answer: Oxidized regenerated cellulose (e.g., Surgicel)

Oxidized regenerated cellulose is a resorbable hemostatic material that can be placed in the surgical site to mechanically and chemically promote clot formation.

A patient taking warfarin is scheduled for implant surgery. The primary concern with this medication is:

Answer: Prolonged bleeding and difficulty achieving hemostasis

Warfarin inhibits vitamin K-dependent clotting factors, significantly prolonging bleeding time and making intraoperative and post-operative hemostasis more challenging.

Which NSAID should be avoided in patients with known aspirin sensitivity who require post-implant pain management?

Answer: Ketorolac

Ketorolac is an NSAID that can trigger cross-reactive hypersensitivity (aspirin-exacerbated respiratory disease) in aspirin-sensitive patients and should be avoided.

What is the rationale for prescribing a short course of systemic antibiotics AFTER implant surgery (post-operative antibiotic therapy)?

Answer: To prevent or treat early-stage peri-implant infection during the critical healing window

Post-operative antibiotics help prevent bacterial colonization of the implant surface and surrounding tissues during the vulnerable early healing phase before re-epithelialization.

Which drug interaction is most clinically significant when a patient is prescribed both an NSAID (ibuprofen) and a blood pressure medication from the ACE inhibitor class?

Answer: NSAIDs can reduce the antihypertensive efficacy of ACE inhibitors and increase renal risk

NSAIDs reduce renal prostaglandin synthesis, which can blunt the antihypertensive effect of ACE inhibitors and increase the risk of acute kidney injury.