Comparison of Different Antibiotic Regimes for Preventive Tooth Extractions in Patients with Antiresorptive Intake—A Retrospective Cohort Study

Abstract

In the present study, the impacts on success rates between three different antibiotic regimes in patients receiving preventive tooth extraction during/after antiresorptive treatment were compared. For the retrospective analysis, we enrolled patients who had undergone tooth extraction from 2009 to 2019 according to the specified preventive conditions under antiresorptive therapy. Three antibiotic regimens were distinguished: (Group 1) intravenous for 7 days, (Group 2) oral for 14 days, and (Group 3) oral for 7 days of application. The primary endpoint was the occurrence of medication-related osteonecrosis of the jaw at 12 weeks after surgery. A total of 760 patients and 1143 extraction regions were evaluated (Group 1 n = 719; Group 2 n = 126; Group 3 n = 298). The primary endpoint showed no significant difference in the development of medication-related osteonecrosis of the jaw between the groups studied (Group 1 n = 50/669 (7%); Group 2 n = 9/117 (7%); Group 3 n = 17/281 (6%); p = 0.746). Overall, the success rate was 93% after intervention when preventive measures were followed. With the same success rate, a reduced, oral administration of antibiotics seems to be sufficient regarding the possible spectrum of side effects, the development of resistance and the health economic point of view.

Unveiling Medication-Related Osteonecrosis of the Jaw: A Rapid Review of Etiology, Drug Holidays, and Treatment Strategies

“…This approach is particularly recommended for patients who are not eligible for surgery or prefer non-surgical interventions. The study compared three antibiotic regimens for preventing MRONJ in patients undergoing tooth extractions while on antiresorptive therapy, finding no significant difference in MRONJ development among groups treated with intravenous antibiotics for 7 days, oral antibiotics for 14 days, or oral antibiotics for 7 days [61]. This indicates that reduced oral antibiotic administration duration can be sufficient for MRONJ prevention when combined with proper preventive measures [61].…”

“…The study compared three antibiotic regimens for preventing MRONJ in patients undergoing tooth extractions while on antiresorptive therapy, finding no significant difference in MRONJ development among groups treated with intravenous antibiotics for 7 days, oral antibiotics for 14 days, or oral antibiotics for 7 days [61]. This indicates that reduced oral antibiotic administration duration can be sufficient for MRONJ prevention when combined with proper preventive measures [61]. Studies on the systemic administration of ampicillin/sulbactam and clindamycin for MRONJ demonstrate their effectiveness in reaching therapeutic jawbone concentrations [23,62].…”