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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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Autores principales: Avishai, Gal, Muchnik, Daniel, Masri, Daya, Zlotogorski-Hurvitz, Ayelet, Chaushu, Liat
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8999581/
https://www.ncbi.nlm.nih.gov/pubmed/35407415
http://dx.doi.org/10.3390/jcm11071807
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author Avishai, Gal
Muchnik, Daniel
Masri, Daya
Zlotogorski-Hurvitz, Ayelet
Chaushu, Liat
author_facet Avishai, Gal
Muchnik, Daniel
Masri, Daya
Zlotogorski-Hurvitz, Ayelet
Chaushu, Liat
author_sort Avishai, Gal
collection PubMed
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 (p = 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 (p = 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.
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spelling pubmed-89995812022-04-12 Minimizing MRONJ after Tooth Extraction in Cancer Patients Receiving Bone-Modifying Agents Avishai, Gal Muchnik, Daniel Masri, Daya Zlotogorski-Hurvitz, Ayelet Chaushu, Liat J Clin Med Article 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 (p = 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 (p = 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. MDPI 2022-03-25 /pmc/articles/PMC8999581/ /pubmed/35407415 http://dx.doi.org/10.3390/jcm11071807 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Avishai, Gal
Muchnik, Daniel
Masri, Daya
Zlotogorski-Hurvitz, Ayelet
Chaushu, Liat
Minimizing MRONJ after Tooth Extraction in Cancer Patients Receiving Bone-Modifying Agents
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 Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8999581/
https://www.ncbi.nlm.nih.gov/pubmed/35407415
http://dx.doi.org/10.3390/jcm11071807
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