Influence of dentures in the initial occurrence site on the prognosis of bisphosphonate-related osteonecrosis of the jaws: a retrospective study

Hirabayashi, Yoko; Kawabe, Mutuki; Kimura, Hiroto; Kurita, K.; Fukuta, Jinichi; Urade, Masahiro

doi:10.1016/j.oooo.2012.04.002

Cited by 25 publications

(20 citation statements)

References 22 publications

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“…for the patients with implants,in 1 case Z & P4n.s.n.s.n.s.n.s.RS with 119 ONJ patients, 4 due to dental implantsDentureAuthor Year ReferenceStudy typePatientsPrimary Disease in BP-ONJBP/DenosumabBP-ONJ CasesComment Nibbe 2015 [15]RS424 patients with oral/IV BP or denosumab.128 patients with IV BP or denosumab - further investigation of this group68 patients with denturesn.s. in all casesOral/IV BPDenosumab16424 patients with oral or IV BP were analyzed, 21 BP-ONJ, only IV BP patients for further analysis34 removable dentures → 11 BP-ONJ34 fixed partial denture → 5 BP-ONJ60 patients without denture → 5 BP-ONJONJ only in patients with IV BP or denosumab Hasegawa 2012 [43]RSQuestionnaire was sent to 248 medical institutions regarding BP-ONJ250 patients99 with dentures151 without denturesn.s.Oral/IV BP99151 osteonecrosis patients without denture had a longer osteonecrosis free time.Most ONJ in the mandible with a focus on the premolar and molar region154 patients with IV BP, 102 with oral BP, 7 both Jabbour 2012 [35]RS14 patients with BP-ONJ4 due to denturesOsteoporosis 2kidney cancer 1breast cancer 1A P4RS analyzing the reason for osteonecroses Vahtsevanos 2009 [39]RS1,621 patients with IV BPn.s.n.s. for the denture patients2424 out of 80 BP-ONJ patients denture as triggering factor diseases and BP for the patients with dentures n.s.…”

Section: Resultsmentioning

confidence: 99%

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Dental implants in patients treated with antiresorptive medication – a systematic literature review

et al. 2016

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ObjectiveBisphosphonate-associated osteonecrosis of the jaws (BP-ONJ) is triggered by inflammatory processes. Typical trigger factors are periodontal disease, denture pressure sores, and surgical interventions such as tooth extractions. Unfortunately there is only little data on how to proceed with implant therapy in patients with bisphosphonate treatment. This topic is not addressed in the German guidelines on medication-associated osteonecrosis. Therefore a systematic literature review was performed.MethodsThe PICO design was used: (Patients) For which subclientel of patients with antiresorptive therapy (intervention) do dental implants have a benefit (control) compared to forgoing dental implants (outcome) in regards to oral rehabilitation and quality of life without having a substantial risk of BP-ONJ development? A PubMed search was performed including all studies dealing with this topic. Case reports and studies with less than 5 cases were excluded.ResultsThere is only very little data available, mostly retrospective case series. 50 articles were analyzed in detail. BP-ONJ can be triggered by dental implants and by dentures in patients with benign and malignant primary diseases. In most studies, analyzing osteoporosis patients only, no cases of BP-ONJ were observed in patients with implant therapy in the time span observed. There are no studies about implant therapy in patients with malignant diseases. Many case series analyzing the trigger factors for BP-ONJ describe dentures as one of the main causes. Perioperative antimicrobial prophylaxis has a benefit in the prevention of BP-ONJ development.ConclusionSuccessful implant therapy is possible in patients receiving antiresorptive therapy. The possibility of osteonecrosis development needs to be explained to the patient. An individual risk assessment is essential, taking the primary disease with the medication and further wound-healing-compromising diseases and medications into account. If possible, bone augmentations should be avoided, and a perioperative antimicrobiological prophylaxis is strongly recommended in these patients.

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Section: Resultsmentioning

confidence: 99%

“…The literature dealing with this topic can be separated into two groups:BP-ONJ case series for which varying amounts are caused by dentures in patients with malignant and benign diseases [2, 33–42] andstudies performed on BP patients with dentures analyzing the frequency of BP-ONJ [15, 43]. …”

Section: Resultsmentioning

confidence: 99%

Dental implants in patients treated with antiresorptive medication – a systematic literature review

et al. 2016

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“…Previous studies suggested that a number of risk factors may have an ‘additive’ impact on ONJ pathogenesis, therefore leading to shorter TTO (Bamias et al , ; Mavrokokki et al , ; Pozzi et al , ; Boonyapakorn et al , ; Palaska et al , ; Vahtsevanos et al , ; Saia et al , ; Hasegawa et al , ; Thumbigere‐Math et al , ; Fleisher et al , ; Watters et al , ). These factors included corticosteroid use, smoking, alcohol, T2DM, dental extraction and use of dentures (Bamias et al , ; Mavrokokki et al , ; Pozzi et al , ; Boonyapakorn et al , ; Palaska et al , ; Vahtsevanos et al , ; Saia et al , ; Hasegawa et al , ; Watters et al , ). Our study considered up to seven risk factors in a multivariable regression model (Harrell et al , ) and shows that none of the previously suggested variables is associated with shorter TTO, including dental risk factors (alveolar surgery and use of dentures).…”

Section: Discussionmentioning

confidence: 99%

Time to onset of bisphosphonate‐related osteonecrosis of the jaws: a multicentre retrospective cohort study

Fung

Bedogni

et al. 2017

Oral Diseases

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Objectives: Osteonecrosis of the jaw (ONJ) is a potentially severe adverse effect of bisphosphonates (BP). Although the risk of ONJ increases with increasing duration of BP treatment, there are currently no reliable estimates of the ONJ time to onset (TTO). The objective of this study was to estimate the TTO and associated risk factors in BP-treated patients. Subjects and methods:Retrospective analysis of data from 22 secondary care centres in 7 countries relevant to 349 patients who developed BP-related ONJ between 2004 and 2012. Results:The median (95%CI) TTO was 6.0 years in patients treated with alendronate (n = 88) and 2.2 years in those treated with zoledronate (n = 218). Multivariable Cox regression showed that dentoalveolar surgery was inversely associated, and the use of antiangiogenics directly associated, with the TTO in cancer patients treated with zoledronate. Accepted ArticleThis article is protected by copyright. All rights reserved. Conclusions:The incidence of ONJ increases with the duration of BP therapy, with notable differences observed with respect to BP type and potency, route of administration and underlying disease. When data are stratified by BP type, a time of 6.0 and 2.2 years of oral alendronate of intravenous zoledronate therapy, respectively, is required for 50% of patients to develop ONJ. After stratification by disease, a time of 5.3 and 2.2 years of BP therapy is required for 50% of patients with osteoporosis and cancer, respectively, to develop ONJ. These findings have significant implications for the design of future clinical studies and the development of risk reduction strategies aimed at either assessing or modulating the risk of ONJ associated with BP.

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“…[6][7][8]16 All the presented patients favored the prosthodontic solution with an obturator instead of a Although obturator treatment is a well-documented treatment after ablative cancer surgery in the maxilla, 1,2,5,6,9,12,13,22 a literature search failed to reveal clinical studies that examined the long-term performance of obturator prostheses for these defects in patients with MRONJ. Removable prosthodontic rehabilitation of patients with MRONJ is under scientific debate because denture trauma has been mentioned as a risk factor for MRONJ development, 26 and few reports are available about optimal denture base design for this patient cohort. 28 BRONJ recurrence was not reported in any of the described patients, although all obturator prostheses were partly supported by oral mucosa.…”

Section: Discussionmentioning

confidence: 99%

“…The disease poses new challenges for prosthodontists and surgeons. 14,15,[23][24][25][26][27][28][29] MRONJ may be induced by a variety of established and new antiresorptive or antineoangiogenetic drugs, including bisphosphonates (BRONJ), denosumab, or other agents. 15 After successful surgical debridement of the necrotic bone, pain relief, and elimination of inflammatory signs, patients are often left with maxillary defects that are too large for predictable primary defect closure.…”

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confidence: 99%

Conservative management of medication-related osteonecrosis of the maxilla with an obturator prosthesis

Troeltzsch¹,

Probst²,

Troeltzsch³

et al. 2015

The Journal of Prosthetic Dentistry

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Influence of dentures in the initial occurrence site on the prognosis of bisphosphonate-related osteonecrosis of the jaws: a retrospective study

Cited by 25 publications

References 22 publications

Dental implants in patients treated with antiresorptive medication – a systematic literature review

Dental implants in patients treated with antiresorptive medication – a systematic literature review

Time to onset of bisphosphonate‐related osteonecrosis of the jaws: a multicentre retrospective cohort study

Conservative management of medication-related osteonecrosis of the maxilla with an obturator prosthesis

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