Aims To determine the incidence of medication-related osteonecrosis of the jaw in patients prescribed oral bisphosphonate medication following dental extraction in a dedicated clinic within the Department of Oral Surgery of King's College Hospital. The effect of factors such as sex, duration of therapy, medical comorbidities and site of extraction, which have previously been reported to significantly affect the risk of developing osteonecrosis of the jaw, was also examined.Materials and methods Data were gathered from the dental records of patients who had extractions over an eight-year period and were included in this retrospective study. Patients with previous or current exposure to intravenous bisphosphonates, denosumab, novel-targeted chemotherapies used in the oncology setting or radiotherapy to the head and neck were excluded from this study.Results The incidence of medication-related osteonecrosis of the jaw following tooth extraction in this group of 652 was 0.8%. A significantly increased risk of developing medication-related osteonecrosis of the jaw was evident in patients prescribed oral bisphosphonates for four years or more (p = 0.02), with an incidence in this group of 1.6%.Conclusion This study demonstrates that, following dental extraction, patients who are prescribed oral bisphosphonates are at risk of developing medication-related osteonecrosis of the jaw and that this risk increases significantly when the patient has been taking the bisphosphonate for four years or more.
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http://dx.doi.org/10.1038/s41415-021-3620-9 | DOI Listing |
BMC Oral Health
December 2024
Department of Oral and Maxillofacial Surgery, Fujian Medical University Union Hospital, Fuzhou, China.
Background: While the surgical treatment of mandibular stage 3 medication-related osteonecrosis of the jaw (MRONJ) is well-documented, research on maxillary stage 3 MRONJ is limited. Antiresorptive medications can induce MRONJ and atypical femoral fracture (AFF), but their impact on the feasibility of using fibula flaps for reconstruction remains controversial. This study aimed to assess the surgical outcomes and functional recovery of fibula flap reconstruction for maxillary stage 3 MRONJ, considering both recipient and donor site outcomes.
View Article and Find Full Text PDFBr Dent J
December 2024
UCL Eastman Dental Institute, University College London, United Kingdom.
Introduction In the UK, more than 18 million extractions are performed annually. Healing after extraction is often uneventful, but there are rare cases where weeks or months pass and an extraction socket does not heal.Aim The aim of this study is to provide a review of cases in which a non-healing extraction socket is attributed to a serious systemic disease or malignancy, or an adverse consequence of systemic therapy.
View Article and Find Full Text PDFJ Oral Maxillofac Surg
December 2024
Assistant Professor, Research and Data Development, The Securities and Exchange Commission, Bangkok, Thailand.
Background: Medication-related osteonecrosis of the jaw (MRONJ) is a serious complication associated with the use of antiresorptive agents, impacting patient quality of life and treatment outcomes. Predictive modeling may aid in a better understanding of MRONJ development.
Purpose: The study aimed to evaluate machine learning (ML)-based models for predicting MRONJ in patients receiving antiresorptive therapy.
Front Oral Health
December 2024
Clinic of Maxillofacial Surgery, University Hospital Brno, Brno, Czechia.
Both denosumab (DMB) and bisphosphonates (BPs), antiresorptive drugs (ARDs) used for the treatment of osteoporosis and oncological disorders, are known for their potential to cause medication-related osteonecrosis of the jaws (MRONJ). Besides ARDs, statins were recently associated with MRONJ development, especially in patients taking higher doses of statins for a longer period of time. Here, we report a case of a female patient with osteoporosis using statins and treated with alendronate for 3 years who rapidly developed MRONJ stage III after only a single low dose of DMB.
View Article and Find Full Text PDFTissue Eng Regen Med
December 2024
Department of Oral and Maxillofacial Surgery, College of Dentistry, Gangneung-Wonju National University, 7 Jukheon-gil, Gangneung-si, Gangwon-do, 25457, Republic of Korea.
Background: Osteoporosis, characterized by decreased bone mineral density due to an imbalance between osteoblast and osteoclast activity, poses significant challenges in bone healing, particularly in postmenopausal women. Current treatments, such as bisphosphonates, are effective but associated with adverse effects like medication-related osteonecrosis of the jaw, necessitating safer alternatives.
Methods: This study investigated the use of L-serine-incorporated gelatin sponges for bone regeneration in calvarial defects in an ovariectomized rat model of osteoporosis.
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