Radiographic predictors for MRONJ in oncologic patients undergoing tooth extraction
Abstract Tooth extraction is a risk factor for the development of osteonecrosis of the jaw following treatment with antiresorptive drugs (ARDs), but not all extraction sites develop this pathology. Therefore, we aimed to identify local radiographic predictors of Medication-Related Osteonecrosis of t...
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| Format: | Article |
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Nature Portfolio
2022-07-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-022-15254-y |
| _version_ | 1811323413200896000 |
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| author | Catalina Moreno-Rabié Laurence Lapauw Hugo Gaêta-Araujo André Ferreira-Leite Wim Coucke Tim van den Wyngaert Reinhilde Jacobs |
| author_facet | Catalina Moreno-Rabié Laurence Lapauw Hugo Gaêta-Araujo André Ferreira-Leite Wim Coucke Tim van den Wyngaert Reinhilde Jacobs |
| author_sort | Catalina Moreno-Rabié |
| collection | DOAJ |
| description | Abstract Tooth extraction is a risk factor for the development of osteonecrosis of the jaw following treatment with antiresorptive drugs (ARDs), but not all extraction sites develop this pathology. Therefore, we aimed to identify local radiographic predictors of Medication-Related Osteonecrosis of the Jaw (MRONJ) in panoramic images of oncologic patients undergoing tooth extraction. Based on a retrospective longitudinal cohort study design, patients were included if undergoing one or more tooth extraction, with at least one administration of ARDs, and presence of pre- and post-operative panoramic radiographs. After data collection, blinded and independent observations were performed. Eleven distinct imaging-related parameters were assessed preoperatively and five postoperatively, at each extraction site. A case–control and subgroup analysis assessing MRONJ development was performed. Significance level is set to 0.05 (5%). A total of 77 oncologic patients were selected, undergoing 218 tooth extractions, from which 63 teeth (29%) in 39 patients (51%) developed MRONJ. Results showed that patients developed significantly more MRONJ with longer ARD treatment (p = 0.057), teeth with absent and incomplete endodontic fillings with caries, widened periodontal ligament space and/or periapical lesions (p = 0.005), and sclerotic and heterogenous bone patterns (p = 0.005). In conclusion, tooth extraction sites presenting with infections and bone sclerosis are at higher risk to develop MRONJ. |
| first_indexed | 2024-04-13T13:54:40Z |
| format | Article |
| id | doaj.art-a014647ed75f4b09af2e403263c55e7f |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-04-13T13:54:40Z |
| publishDate | 2022-07-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-a014647ed75f4b09af2e403263c55e7f2022-12-22T02:44:14ZengNature PortfolioScientific Reports2045-23222022-07-0112111110.1038/s41598-022-15254-yRadiographic predictors for MRONJ in oncologic patients undergoing tooth extractionCatalina Moreno-Rabié0Laurence Lapauw1Hugo Gaêta-Araujo2André Ferreira-Leite3Wim Coucke4Tim van den Wyngaert5Reinhilde Jacobs6OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University of LeuvenOMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University of LeuvenOMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University of LeuvenOMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University of LeuvenCertified Freelance StatisticianDepartment of Nuclear Medicine, Antwerp University HospitalOMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University of LeuvenAbstract Tooth extraction is a risk factor for the development of osteonecrosis of the jaw following treatment with antiresorptive drugs (ARDs), but not all extraction sites develop this pathology. Therefore, we aimed to identify local radiographic predictors of Medication-Related Osteonecrosis of the Jaw (MRONJ) in panoramic images of oncologic patients undergoing tooth extraction. Based on a retrospective longitudinal cohort study design, patients were included if undergoing one or more tooth extraction, with at least one administration of ARDs, and presence of pre- and post-operative panoramic radiographs. After data collection, blinded and independent observations were performed. Eleven distinct imaging-related parameters were assessed preoperatively and five postoperatively, at each extraction site. A case–control and subgroup analysis assessing MRONJ development was performed. Significance level is set to 0.05 (5%). A total of 77 oncologic patients were selected, undergoing 218 tooth extractions, from which 63 teeth (29%) in 39 patients (51%) developed MRONJ. Results showed that patients developed significantly more MRONJ with longer ARD treatment (p = 0.057), teeth with absent and incomplete endodontic fillings with caries, widened periodontal ligament space and/or periapical lesions (p = 0.005), and sclerotic and heterogenous bone patterns (p = 0.005). In conclusion, tooth extraction sites presenting with infections and bone sclerosis are at higher risk to develop MRONJ.https://doi.org/10.1038/s41598-022-15254-y |
| spellingShingle | Catalina Moreno-Rabié Laurence Lapauw Hugo Gaêta-Araujo André Ferreira-Leite Wim Coucke Tim van den Wyngaert Reinhilde Jacobs Radiographic predictors for MRONJ in oncologic patients undergoing tooth extraction Scientific Reports |
| title | Radiographic predictors for MRONJ in oncologic patients undergoing tooth extraction |
| title_full | Radiographic predictors for MRONJ in oncologic patients undergoing tooth extraction |
| title_fullStr | Radiographic predictors for MRONJ in oncologic patients undergoing tooth extraction |
| title_full_unstemmed | Radiographic predictors for MRONJ in oncologic patients undergoing tooth extraction |
| title_short | Radiographic predictors for MRONJ in oncologic patients undergoing tooth extraction |
| title_sort | radiographic predictors for mronj in oncologic patients undergoing tooth extraction |
| url | https://doi.org/10.1038/s41598-022-15254-y |
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