<b>Importance of Professional Oral Hygiene in Preventing Medication-related Osteonecrosis of the Jaw </b>

Abstract

It has been reported that bisphosphonate treatment induces medication-related osteonecrosis of the jaw (MRONJ). Although dental extraction, periodontal disease and systemic disease are noted as risk factors for MRONJ, there are few reports examining the relationship between oral hygiene and MRONJ. The purpose of this retrospective study was to determine risk factors for MRONJ occurrence, and to assess whether MRONJ occurrence is suppressed by professional oral hygiene management or not.The participants were patients undergoing zoledronate treatment. Dental examination was undertaken by dentists or dental hygienists every six months during the consultation period. The participants were divided into intervention and non-intervention groups. The former underwent professional oral hygiene management by a dental hygienist every three or four weeks, whereas the latter group did not desire professional oral hygiene management.Two participants in the intervention group (n = 40) and four participants in the nonintervention group(n=11)developed MRONJ. The incidence of MRONJ was significantly reduced in the intervention group when compared with the non-intervention group(p= 0.015). The onset of MRONJ in the intervention group was significantly prolonged(p= 0.003). In addition, proportional hazards analysis indicated that the only significant factor in the development of MRONJ was the delivery of oral hygiene management(p<0.05), and the hazard ratio was 0.109.It is suggested that oral hygiene management suppressed the development of MRONJ. There is a possibility that MRONJ could be suppressed by regular oral hygiene management performed by a dental hygienist.

Selection of Angiogenic Markers that Predict the Transition from Bisphosphonate Exposure to MRONJ in a Rat Model

“…Other studies suggest that impeccable oral hygiene and limited surgical intervention may allow some mitigation of the progression of the disease [30,31]. These observations suggest that it is not only exposure to bisphosphonates that determines the progression of the disease, but also the metabolic activity within the bone and the surrounding oral and extra-oral tissue environment (including the blood supply) which determine the onset and progression of the disease.…”

Effect of water temperature during ultrasonic denture cleaning

“…The importance of oral hygiene has also been well-recognized since Yoneyama et al (1) reported that good oral hygiene prevents aspiration pneumonia in the elderly. In particular, the preventive effects of perioperative oral management and infection control have also been reported in patients with medication-related osteonecrosis of the jaw and in those undergoing surgical therapy, chemotherapy, and radiation therapy for malignant tumors (2)(3)(4)(5). Denture plaque control (i.e., denture cleaning) is essential for maintaining oral hygiene in patients who wear dentures.…”