Minimizing MRONJ after Tooth Extraction in Cancer Patients Receiving Bone-Modifying Agents
Background: Medication-related osteonecrosis of the jaws (MRONJ) is a mucosal lesion of the maxillofacial region with necrotic bone exposure. MRONJ is believed to be multifactorial. Tooth extraction is debatably a risk factor for MRONJ. The targets of the present study were to examine MRONJ occurren...
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| Format: | Article |
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MDPI AG
2022-03-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/7/1807 |
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| author | Gal Avishai Daniel Muchnik Daya Masri Ayelet Zlotogorski-Hurvitz Liat Chaushu |
| author_facet | Gal Avishai Daniel Muchnik Daya Masri Ayelet Zlotogorski-Hurvitz Liat Chaushu |
| author_sort | Gal Avishai |
| collection | DOAJ |
| description | Background: Medication-related osteonecrosis of the jaws (MRONJ) is a mucosal lesion of the maxillofacial region with necrotic bone exposure. MRONJ is believed to be multifactorial. Tooth extraction is debatably a risk factor for MRONJ. The targets of the present study were to examine MRONJ occurrence in patients using bone modifying agents (BMAs) for oncology indications and undergoing a dental extraction, and to assess whether suspected predisposing factors can predict MRONJ. Materials and Methods: This retrospective, cohort study included all patients fitting the inclusion criteria and a large tertiary medical center. Data were obtained from the hospital’s medical records using a structured questionnaire. Results: We performed 103 extractions on 93 patients. Local inflammation/infection of the extraction site was most associated with a complication (<i>p</i> = 0.001) OR = 13.46, 95% CI = (1.71, 105.41), OR = 13.5. When the indication for extraction was periodontal disease, vertical root fracture, or periapical pathosis, the odds of developing MRONJ were 4.29 times higher than for all other indications (<i>p</i> = 0.1), OR = 4.29, 95% CI = (1.16, 15.85). A significant association was found between the time of onset of BMA treatment and time of extraction and the development of MRONJ, OR = 3.34, 95% CI = (1.01, 10.18). Other variables did not correlate with the development of MRONJ. Conclusion: Local inflammation/infection and onset of BMA treatment prior to extraction yield a 10.23 times higher chance of developing MRONJ following tooth extraction. Future protocols should use this information to minimize MRONJ incidence. |
| first_indexed | 2024-03-09T11:44:05Z |
| format | Article |
| id | doaj.art-ff9ca163469947e3b17127b18a9e7f7f |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T11:44:05Z |
| publishDate | 2022-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-ff9ca163469947e3b17127b18a9e7f7f2023-11-30T23:27:08ZengMDPI AGJournal of Clinical Medicine2077-03832022-03-01117180710.3390/jcm11071807Minimizing MRONJ after Tooth Extraction in Cancer Patients Receiving Bone-Modifying AgentsGal Avishai0Daniel Muchnik1Daya Masri2Ayelet Zlotogorski-Hurvitz3Liat Chaushu4Department of Oral and Maxillofacial Surgery, Rabin Medical Center—Beilinson Hospital, Petach Tikva 49414, IsraelDepartment of Oral and Maxillofacial Surgery, Rabin Medical Center—Beilinson Hospital, Petach Tikva 49414, IsraelDepartment of Oral and Maxillofacial Surgery, Rabin Medical Center—Beilinson Hospital, Petach Tikva 49414, IsraelDepartment of Oral and Maxillofacial Surgery, Rabin Medical Center—Beilinson Hospital, Petach Tikva 49414, IsraelDepartment of Periodontology and Oral Implantology, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv 69978, IsraelBackground: Medication-related osteonecrosis of the jaws (MRONJ) is a mucosal lesion of the maxillofacial region with necrotic bone exposure. MRONJ is believed to be multifactorial. Tooth extraction is debatably a risk factor for MRONJ. The targets of the present study were to examine MRONJ occurrence in patients using bone modifying agents (BMAs) for oncology indications and undergoing a dental extraction, and to assess whether suspected predisposing factors can predict MRONJ. Materials and Methods: This retrospective, cohort study included all patients fitting the inclusion criteria and a large tertiary medical center. Data were obtained from the hospital’s medical records using a structured questionnaire. Results: We performed 103 extractions on 93 patients. Local inflammation/infection of the extraction site was most associated with a complication (<i>p</i> = 0.001) OR = 13.46, 95% CI = (1.71, 105.41), OR = 13.5. When the indication for extraction was periodontal disease, vertical root fracture, or periapical pathosis, the odds of developing MRONJ were 4.29 times higher than for all other indications (<i>p</i> = 0.1), OR = 4.29, 95% CI = (1.16, 15.85). A significant association was found between the time of onset of BMA treatment and time of extraction and the development of MRONJ, OR = 3.34, 95% CI = (1.01, 10.18). Other variables did not correlate with the development of MRONJ. Conclusion: Local inflammation/infection and onset of BMA treatment prior to extraction yield a 10.23 times higher chance of developing MRONJ following tooth extraction. Future protocols should use this information to minimize MRONJ incidence.https://www.mdpi.com/2077-0383/11/7/1807MRONJdental extraction complicationsoral surgery in oncology |
| spellingShingle | Gal Avishai Daniel Muchnik Daya Masri Ayelet Zlotogorski-Hurvitz Liat Chaushu Minimizing MRONJ after Tooth Extraction in Cancer Patients Receiving Bone-Modifying Agents Journal of Clinical Medicine MRONJ dental extraction complications oral surgery in oncology |
| title | Minimizing MRONJ after Tooth Extraction in Cancer Patients Receiving Bone-Modifying Agents |
| title_full | Minimizing MRONJ after Tooth Extraction in Cancer Patients Receiving Bone-Modifying Agents |
| title_fullStr | Minimizing MRONJ after Tooth Extraction in Cancer Patients Receiving Bone-Modifying Agents |
| title_full_unstemmed | Minimizing MRONJ after Tooth Extraction in Cancer Patients Receiving Bone-Modifying Agents |
| title_short | Minimizing MRONJ after Tooth Extraction in Cancer Patients Receiving Bone-Modifying Agents |
| title_sort | minimizing mronj after tooth extraction in cancer patients receiving bone modifying agents |
| topic | MRONJ dental extraction complications oral surgery in oncology |
| url | https://www.mdpi.com/2077-0383/11/7/1807 |
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