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- Title
Local radiographic risk factors for MRONJ in osteoporotic patients undergoing tooth extraction.
- Authors
Moreno‐Rabié, Catalina; Gaêta‐Araujo, Hugo; Ferreira‐Leite, André; Coucke, Wim; Gielen, Evelien; Van den Wyngaert, Tim; Jacobs, Reinhilde
- Abstract
Objective: To identify local radiographic risk factors for Medication‐Related Osteonecrosis of the Jaws (MRONJ) in osteoporotic patients treated with antiresorptive drugs (ARD) and undergoing tooth extraction. Material and Methods: Patients were included in this retrospective, longitudinal, case‐control study, if having at least one administration of ARD, underwent tooth extraction(s), and had pre‐ and post‐operative panoramic radiographs. Additionally, a matched control group was selected. Three calibrated, blinded, and independent observers assessed each tooth extraction site. Statistical analysis compared control against study group, and within the latter, sites MRONJ+ and MRONJ−. Results: In total, 120 patients (99 females/21 males) with 354 tooth extractions were included, from which nine patients (7.5%) and eleven tooth extraction sites (3.1%) developed MRONJ. When comparing control with study group, the latter showed significantly more thickened lamina dura, persistence of the alveolar socket, heterogeneous bone patterns, and sequestrum formation. In the study group, MRONJ developed significantly more in males (19%, p = 0.049), smokers (25%, p = 0.008), in the mandible (82%, p = 0.027), when identifying a radiolucent or sclerotic trabecular pattern (p = 0.004) or when extracting teeth with furcation involvement (p < 0.001), root remnants (p = 0.017), or unrestored caries lesions (p = 0.005). Conclusions: Tooth extraction sites showing radiographic signs of chronic dental infection are prone to MRONJ.
- Subjects
JAW diseases; DIPHOSPHONATES; FISHER exact test; RETROSPECTIVE studies; DESCRIPTIVE statistics; LONGITUDINAL method; PRE-tests &; post-tests; CASE-control method; OSTEOPOROSIS; DENTAL extraction; COMPARATIVE studies; OSTEONECROSIS; DISEASE complications
- Publication
Oral Diseases, 2024, Vol 30, Issue 3, p1632
- ISSN
1354-523X
- Publication type
Article
- DOI
10.1111/odi.14496