AI Article Synopsis
- Root amputation, single tooth extraction, severe tooth mobility, and unclosed wounds are linked to a higher risk of medication-related osteonecrosis of the jaw (MRONJ) in patients on bisphosphonates.
- The study reviewed various risk factors such as demographics, type/duration of bisphonate use, and surgical approaches after tooth extraction to better understand MRONJ incidence.
- To reduce MRONJ risk, the authors recommend using a minimally traumatic extraction technique, ensuring bone edges are removed, and closing mucosal wounds for bisphonate patients.
Article Abstract
Unlabelled: Root amputation, extraction of a single tooth, bone loss or severe tooth mobility, and an unclosed wound were significantly associated with increased risk of developing medication-related osteonecrosis of the jaw (MRONJ). We recommend a minimally traumatic extraction technique, removal of any bone edges, and mucosal wound closure as standard procedures in patients receiving bisphosphonates.
Introduction: Osteonecrosis of the jaws can occur following tooth extraction in patients receiving bisphosphonate drugs. Various strategies for minimizing the risk of MRONJ have been advanced, but no studies have comprehensively analyzed the efficacy of factors such as primary wound closure, demographics, and drug holidays in reducing its incidence. The purpose of this study was to retrospectively investigate the relationships between these various risk factors after tooth extraction in patients receiving oral bisphosphonate therapy.
Methods: Risk factors for MRONJ after tooth extraction were evaluated using univariate and multivariate analysis. All patients were investigated with regard to demographics; type and duration of oral bisphosphonate use; whether they underwent a discontinuation of oral bisphosphonates before tooth extraction (drug holiday), and the duration of such discontinuation; and whether any additional surgical procedures (e.g., incision, removal of bone edges, root amputation) were performed.
Results: We found that root amputation (OR = 6.64), extraction of a single tooth (OR = 3.70), bone loss or severe tooth mobility (OR = 3.60), and an unclosed wound (OR = 2.51) were significantly associated with increased risk of developing MRONJ.
Conclusions: We recommend a minimally traumatic extraction technique, removal of any bone edges, and mucosal wound closure as standard procedures in patients receiving bisphosphonates. We find no evidence supporting the efficacy of a pre-extraction short-term drug holiday from oral bisphosphonates in reducing the risk of MRONJ.
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| http://dx.doi.org/10.1007/s00198-017-4063-7 | DOI Listing |
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