The risk of osteonecrosis on alveolar healing after tooth extraction and systemic administration of antiresorptive drugs in rodents: a systematic review

Poubel, Victor Lousan do Nascimento; Silva, Carolina Amália Barcellos; Mezzomo, Luís André; Canto, Graziela De Luca; Rivero, Elena Riet Correa

doi:10.1016/j.jcms.2017.11.008

Cited by 20 publications

(13 citation statements)

References 35 publications

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“…MRONJ pathophysiology is apparently multifactorial, and inflammation or infection, trauma, and decreased bone turnover are associated with disease development 1,4 . Although spontaneous development has been described by some authors, in most reports, MRONJ is associated with tooth extraction due to pulp infection, periapical lesions, and bacterial infections 8,13,14 . This connection was observed in an animal study, indicating that such infections precede the appearance of necrotic bone 11,15,16 .…”

Section: Discussionmentioning

confidence: 99%

Antiresorptive medication in oncology: the clinical and dental profile of patients in a reference center

Ferreira

Kemp

Vendruscolo

et al. 2021

JKAOMS

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Objectives: The aim of this study was to evaluate the profile of patients on antiresorptive therapies for cancer treatment and assess presence of oral lesions, oral hygiene status, and knowledge regarding medication-related osteonecrosis of the jaw (MRONJ). Materials and Methods: This was an observational cross-sectional study that evaluated patients treated with antiresorptive medication at a single cancer hospital. Clinical data were collected and oral examination was performed to assess patient oral health. Results: From July 2017 to December 2018, 90 patients were assessed; 64 were female and 26 were male, and the mean age was 61 years. The most common drug was an intravenous bisphosphonate, zoledronic acid. Among the 90 patients, 47 presented with some type of oral disease, isolated or associated. Among these 47 patients, 9 patients (10%) developed osteonecrosis. Oral hygiene was evaluated, and most patients, with or without MRONJ, presented with regular to poor condition. Regarding patient knowledge of the risks of MRONJ and the risks associated with dental surgery, 60% stated that they were not aware of the risks. Conclusion: Identifying the profile of patients and their needs facilitates not only the preventive process, but also the emergence of new therapeutic options. Our study shows that most patients are weakened both by metastatic disease and antineoplastic treatment as well as by issues associated with aging because most were over 60 years of age. Collectively, this information should be considered for management of preventive and therapeutic measures.

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Section: Discussionmentioning

confidence: 99%

Antiresorptive medication in oncology: the clinical and dental profile of patients in a reference center

Ferreira

Kemp

Vendruscolo

et al. 2021

JKAOMS

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“…Invasive dental procedures should be avoided in high-risk patients. As reported in several studies, tooth extraction is a major local factor contributing to the increasing incidence of ONJ in patients taking ARDs [2833343566]. Therefore, it is recommended to treat severely damaged teeth using a conservative endodontic approach with remaining tooth structure instead of extraction [67].…”

Section: Reviewmentioning

confidence: 99%

Dental care for patients taking antiresorptive drugs: a literature review

Song

2019

Restor Dent Endod

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Antiresorptive drugs (ARDs), such as bisphosphonates or denosumab, that prevent bone resorption are widely used in patients with osteoporosis or with cancer that has metastasized to the bones. Although osteonecrosis of the jaw (ONJ) is a well-documented complication of ARD use, the benefits ARDs outweigh the complication. Thus, research has focused on finding ways to prevent or reduce the risk of developing ONJ. Dentists, as part of a multiprofessional team, have a critical role in preventing ONJ. However, many dentists tend to hesitate to provide dental care to patients with ONJ, or tend to think that it is a problem to be dealt with by oral surgeons. This review gives an overview of ARD-related ONJ and provides the guidelines for dental care in patients taking ARDs to lower the risk of developing ONJ.

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“…The major clinical symptoms of ARONJ are progressive destruction of the jaw, prolonged pain, bone exposure, soft tissue swelling, fistula, and infections. Most of those symptoms are intractable, and many severe cases have been reported 8‐10 . Therefore, the diagnosis and treatment of ARONJ should be made early.…”

Section: Introductionmentioning

confidence: 99%

“…Most of those symptoms are intractable, and many severe cases have been reported. [8][9][10] Therefore, the diagnosis and treatment of ARONJ should be made early.…”

Section: Introductionmentioning

confidence: 99%

Intraoral localized methotrexate‐associated lymphoproliferative disorders concurrent with antiresorptive agent‐related osteonecrosis of the jaw: A case report and literature review

Minabe

Suzuki

Komatsu

et al. 2020

Clinical Case Reports

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The risk of osteonecrosis on alveolar healing after tooth extraction and systemic administration of antiresorptive drugs in rodents: a systematic review

Cited by 20 publications

References 35 publications

Antiresorptive medication in oncology: the clinical and dental profile of patients in a reference center

Antiresorptive medication in oncology: the clinical and dental profile of patients in a reference center

Dental care for patients taking antiresorptive drugs: a literature review

Intraoral localized methotrexate‐associated lymphoproliferative disorders concurrent with antiresorptive agent‐related osteonecrosis of the jaw: A case report and literature review

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