Initial Experience on the Outcome of Teeth Extractions in Intravenous Bisphosphonate-Treated Patients: A Cautionary Report

Scoletta, Matteo; Arduino, Paolo Giacomo; Pol, Renato; Arata, Valentina; Silvestri, Stefano; Chiecchio, Andrea; Mozzati, Marco

doi:10.1016/j.joms.2010.07.026

Cited by 52 publications

(48 citation statements)

References 23 publications

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“…In a large prospective study with 220 tooth extractions in 64 patients receiving intravenous BP therapy the postoperative outcome was 97.73% with only five sites of BRONJ after a minimum follow up of 4 months (Scoletta et al, 2011). Their treatment protocol included the use of an ultrasonic surgical device (Mectron Piezosurgery) and the standardized use of autologous plasma rich in growth factors (PRGF).…”

Section: Discussionmentioning

confidence: 99%

Incidence of bisphosphonate-related osteonecrosis of the jaw in high-risk patients undergoing surgical tooth extraction

Bodem

Kargus

Eckstein

et al. 2015

Journal of Cranio-Maxillofacial Surgery

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Section: Discussionmentioning

confidence: 99%

Incidence of bisphosphonate-related osteonecrosis of the jaw in high-risk patients undergoing surgical tooth extraction

Bodem

Kargus

Eckstein

et al. 2015

Journal of Cranio-Maxillofacial Surgery

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“…19 Scoletta et al in 2011 proposed a clinical protocol based on the filling of the extraction site with autologous plasma rich in growth factors (PRGF System; BTI Biotechnology Institute, Vitoria, Spain) and obtained an incidence of post-extractive MRONJ of 2.27%. 25 In 2013, the authors refined the PRGF supported clinical protocol in absence of vestibular split-thickness flap and observed post-extractive MRONJ in 2 of 202 patients, with an incidence of 0.99%. 18 The protocol that we proposed is minimally invasive and well tolerated by all the patients, including patients with serious systemic problems, because it does not provide additional surgical treatment LLLT weekly applications for the first 6 weeks and additional applications until complete mucosal healing 5…”

Section: Discussionmentioning

confidence: 99%

Tooth Extractions in High-Risk Patients Under Bisphosphonate Therapy and Previously Affected With Osteonecrosis of the Jaws

Vescovi

Giovannacci²,

Merigo³

et al. 2015

Journal of Craniofacial Surgery

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Trauma during dental surgery is a predisposing factor for medication-related osteonecrosis of the jaws (MRONJ). There are no specific guidelines for the management of dental extractions in patients under bisphosphonate therapy (BPT). The authors proposed in 2013 a successful protocol for tooth extractions in patients under BPT supported by Nd:YAG low-level laser therapy (LLLT). The aim of this study was to validate the safety and efficacy of this protocol reporting the data related to its application in a particular category of patients under BPT at high risk for MRONJ and who were previously affected with MRONJ. Eighty-two tooth extractions were performed in 36 patients previously affected with MRONJ. Antibiotic treatment was administered 3 days before and 2 weeks after tooth extractions. Patients were additionally treated with Nd:YAG LLLT, 5 applications of 1 minute each. Patients were evaluated 3 days and once a week for 2 months after the extractions and every time they received LLLT. In a total of 82 extractions, minimal bone exposure was observed in 2 cases, treated with Er:YAG laser vaporization and then completely healed. The data confirmed that laser biostimulation is a reliable technique that can be considered in the surgical protocol for patients under BPT.

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“…Bocanegra-Perez et al and Scoletta et al proposed using PRP in a surgical protocol to reduce occurrence of BRONJ in patients under IV Bisphosphonate treatment who required exodontia (34, 44). …”

Section: Discussionmentioning

confidence: 99%

Platelet-Rich Plasma in Treatment of Zoledronic Acid-Induced Bisphosphonate-related osteonecrosis of the jaws

et al. 2014

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Background:Bisphosphonate-related osteonecrosis of the jaws (BRONJ) is a well-known challenging entity warranting management. Platelet-Rich Plasma (PRP) plays an important role in bone biology by enhancing bone repair and regeneration.Objectives:The aim of this animal study was to evaluate the effects of PRP on zoledronic acid-induced BRONJ.Materials and Methods:Seven rats were given 0.04 mg Zoledronic acid intravenously once a week for five weeks. Two weeks later, the animals underwent extraction of their first lower molars, bilaterally. After clinical confirmation of the osteonecrosis, PRP was injected randomly into one of the extraction sockets of each rat. Three weeks later, all rats were sacrificed in order to obtain histological sections. The analysis of epithelialization was performed by McNamar’s test, and the analysis of osteogenesis and angiogenesis was performed by the Wilcoxon Sign Rank test. P value was set at 0.05.Results:We found no significant differences between the two groups regarding the amount of epithelialization, angiogenesis or sequestrum formation (P > 0.05), but a significant difference was seen between the two groups regarding the amount of existing vital bone (P < 0.05).Conclusions:Our study demonstrates positive results (preservation or regeneration of bone) using PRP in treatment of BRONJ. Although PRP may enhance osseous regeneration, long-term follow-ups are required to confirm its benefits.

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Initial Experience on the Outcome of Teeth Extractions in Intravenous Bisphosphonate-Treated Patients: A Cautionary Report

Cited by 52 publications

References 23 publications

Incidence of bisphosphonate-related osteonecrosis of the jaw in high-risk patients undergoing surgical tooth extraction

Incidence of bisphosphonate-related osteonecrosis of the jaw in high-risk patients undergoing surgical tooth extraction

Tooth Extractions in High-Risk Patients Under Bisphosphonate Therapy and Previously Affected With Osteonecrosis of the Jaws

Platelet-Rich Plasma in Treatment of Zoledronic Acid-Induced Bisphosphonate-related osteonecrosis of the jaws

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