Key insights into antiresorptive drug use and osteonecrosis in osteoporotic patients undergoing tooth extractions: A clinical and cone beam computed tomography (CBCT) assessment
Authors' conclusion
Osteoporotic patients under ARD may exhibit thickening of the lamina dura and prolonged post-operative healing. Among these patients, multi-rooted teeth are at higher risk for MRONJ than single-rooted teeth. Sequester formation is a radiographic indicator of osteonecrosis.
Study context
- Population
- Osteoporotic patients undergoing tooth extractions
- Participants
- 176 patients
- Exposure
- Osteoporotic patients on antiresorptive drugs undergoing tooth extraction vs matched controls
- Studyn = 78
- Controlsn = 98reference
- Outcome
- MRONJ after tooth extraction and radiographic (CBCT) effects of ARD
Methodological detailsage-, sex- and tooth-matched controls, three calibrated examiners
- Age-, sex- and tooth-matched controls
- Three calibrated examiners
Main finding
As reported in the abstract
MRONJ after tooth extraction (study group)
| Group | Value | Sites developing medication-related osteonecrosis of the jaws (MRONJ) |
|---|---|---|
| Study | 5% | 5 (2%) |
Study
Value5%
Sites developing medication-related osteonecrosis of the jaws (MRONJ)5 (2%)
Observational data: associations, not effects.
Further findings
Mucosal healing time
- Tomographic features, bisphosphonates vs denosumab · No significant differences
- P > 0.05
Mucosal healing time
- Significantly longer in antiresorptive drugs (ARD)-treated patients than controls
Lamina dura thickening
- Significantly more thickening in ARD-treated patients than controls
MRONJ risk factors (study group)
- MRONJ risk significantly increased with corticosteroid intake and in multi-rooted teeth
Bone sequestrum
- Exclusively observed in osteoporotic patients with post-operative exposed bone or histological evidence of osteonecrosis
Original publication
Key insights into antiresorptive drug use and osteonecrosis in osteoporotic patients undergoing tooth extractions: A clinical and CBCT assessment. Osteoporos Int. Published 20 May 2024. doi:10.
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