The risk of osteonecrosis of the jaw and adverse outcomes in patients using antiresorptive drugs undergoing orthodontic treatment: A systematic review
Objectives: Medication-related osteonecrosis of the jaw (MRONJ) is rare. It is a serious adverse effect of certain drugs, of which bisphosphonates (BPs) are the most widely known. The aim of this systematic review was to analyze all published evidence for the reported adverse outcomes as a result of...
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| Format: | Article |
| Language: | English |
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Elsevier
2021-01-01
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| Series: | Heliyon |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2405844021000190 |
| _version_ | 1818919358866391040 |
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| author | Julian Woolley Oladapo Akintola Julian Yates Monica Diuana Calasans-Maia Jose de Albuquerque Calasans-Maia Iryna Kocherhina Roberto Sacco |
| author_facet | Julian Woolley Oladapo Akintola Julian Yates Monica Diuana Calasans-Maia Jose de Albuquerque Calasans-Maia Iryna Kocherhina Roberto Sacco |
| author_sort | Julian Woolley |
| collection | DOAJ |
| description | Objectives: Medication-related osteonecrosis of the jaw (MRONJ) is rare. It is a serious adverse effect of certain drugs, of which bisphosphonates (BPs) are the most widely known. The aim of this systematic review was to analyze all published evidence for the reported adverse outcomes as a result of orthodontic treatment in patients undergoing antiresorptive therapy. Data: All types of studies involving patients undergoing orthodontic treatment and treated with antiresorptive drugs were considered. A meta-analysis was not conducted due to the high amount of variability and heterogeneity in the reporting and presentation of data among the studies meeting the inclusion criteria. Sources: A systematic search was performed using 4 databases (PubMed, MEDLINE, EMBASE and CINAHL). Study selection: Seven studies matched the inclusion criteria for this review, reporting a total of 29 patients. MRONJ was only reported in 1 patient. The adverse outcomes following orthodontic treatment included difficulty achieving root parallelism (n = 4), difficulty achieving complete space closure (n = 3), exaggerated tooth mobility post-debond (n = 2), increased duration of orthodontic treatment beyond expected completion (n = 1), sclerotic alveolar bone changes seen on post-op radiographic images (n = 2), and an increased amount of root resorption (n = 1). Conclusions: The high amount of heterogeneity and limited evidence precluded a valid interpretation and analysis of the results through pooling of data. Additional data with sufficient quality, a reduction of bias, and a greater prospective cohort of patients is crucial to assess adverse effects, mechanisms of action, and associated risk factors in at-risk patients. Clinical significance: Based on the limited evidence available in the literature, it is unclear whether orthodontic treatment alone can precipitate MRONJ. However, antiresorptive drug therapy may be associated with a sub-optimal treatment outcome. |
| first_indexed | 2024-12-20T01:04:36Z |
| format | Article |
| id | doaj.art-62b7649ddafa47f792a1843aebdddacf |
| institution | Directory Open Access Journal |
| issn | 2405-8440 |
| language | English |
| last_indexed | 2024-12-20T01:04:36Z |
| publishDate | 2021-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Heliyon |
| spelling | doaj.art-62b7649ddafa47f792a1843aebdddacf2022-12-21T19:58:53ZengElsevierHeliyon2405-84402021-01-0171e05914The risk of osteonecrosis of the jaw and adverse outcomes in patients using antiresorptive drugs undergoing orthodontic treatment: A systematic reviewJulian Woolley0Oladapo Akintola1Julian Yates2Monica Diuana Calasans-Maia3Jose de Albuquerque Calasans-Maia4Iryna Kocherhina5Roberto Sacco6King's College Dental Hospital, Oral Surgery Department, London, UKKing's College Dental Hospital, Oral Surgery Department, London, UKThe University of Manchester, Division of Dentistry, School of Medical Sciences, Oral Surgery Department, Manchester, UKUniversidade Federal Fluminense, Dental School, Oral Surgery Department, Rio de Janeiro, BrazilUniversidade Federal Fluminense, Dental School, Orthodontics Department, Rio de Janeiro, BrazilOrthodontics Postgraduate Center, Guy's Dental Hospital, London, UKKing's College Dental Hospital, Oral Surgery Department, London, UK; The University of Manchester, Division of Dentistry, School of Medical Sciences, Oral Surgery Department, Manchester, UK; Corresponding author.Objectives: Medication-related osteonecrosis of the jaw (MRONJ) is rare. It is a serious adverse effect of certain drugs, of which bisphosphonates (BPs) are the most widely known. The aim of this systematic review was to analyze all published evidence for the reported adverse outcomes as a result of orthodontic treatment in patients undergoing antiresorptive therapy. Data: All types of studies involving patients undergoing orthodontic treatment and treated with antiresorptive drugs were considered. A meta-analysis was not conducted due to the high amount of variability and heterogeneity in the reporting and presentation of data among the studies meeting the inclusion criteria. Sources: A systematic search was performed using 4 databases (PubMed, MEDLINE, EMBASE and CINAHL). Study selection: Seven studies matched the inclusion criteria for this review, reporting a total of 29 patients. MRONJ was only reported in 1 patient. The adverse outcomes following orthodontic treatment included difficulty achieving root parallelism (n = 4), difficulty achieving complete space closure (n = 3), exaggerated tooth mobility post-debond (n = 2), increased duration of orthodontic treatment beyond expected completion (n = 1), sclerotic alveolar bone changes seen on post-op radiographic images (n = 2), and an increased amount of root resorption (n = 1). Conclusions: The high amount of heterogeneity and limited evidence precluded a valid interpretation and analysis of the results through pooling of data. Additional data with sufficient quality, a reduction of bias, and a greater prospective cohort of patients is crucial to assess adverse effects, mechanisms of action, and associated risk factors in at-risk patients. Clinical significance: Based on the limited evidence available in the literature, it is unclear whether orthodontic treatment alone can precipitate MRONJ. However, antiresorptive drug therapy may be associated with a sub-optimal treatment outcome.http://www.sciencedirect.com/science/article/pii/S2405844021000190Orthodontic treatmentOrthodonticsOsteonecrosisMRONJTooth movementAntiresorptive drugs |
| spellingShingle | Julian Woolley Oladapo Akintola Julian Yates Monica Diuana Calasans-Maia Jose de Albuquerque Calasans-Maia Iryna Kocherhina Roberto Sacco The risk of osteonecrosis of the jaw and adverse outcomes in patients using antiresorptive drugs undergoing orthodontic treatment: A systematic review Heliyon Orthodontic treatment Orthodontics Osteonecrosis MRONJ Tooth movement Antiresorptive drugs |
| title | The risk of osteonecrosis of the jaw and adverse outcomes in patients using antiresorptive drugs undergoing orthodontic treatment: A systematic review |
| title_full | The risk of osteonecrosis of the jaw and adverse outcomes in patients using antiresorptive drugs undergoing orthodontic treatment: A systematic review |
| title_fullStr | The risk of osteonecrosis of the jaw and adverse outcomes in patients using antiresorptive drugs undergoing orthodontic treatment: A systematic review |
| title_full_unstemmed | The risk of osteonecrosis of the jaw and adverse outcomes in patients using antiresorptive drugs undergoing orthodontic treatment: A systematic review |
| title_short | The risk of osteonecrosis of the jaw and adverse outcomes in patients using antiresorptive drugs undergoing orthodontic treatment: A systematic review |
| title_sort | risk of osteonecrosis of the jaw and adverse outcomes in patients using antiresorptive drugs undergoing orthodontic treatment a systematic review |
| topic | Orthodontic treatment Orthodontics Osteonecrosis MRONJ Tooth movement Antiresorptive drugs |
| url | http://www.sciencedirect.com/science/article/pii/S2405844021000190 |
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