Risk factors of osteonecrosis of the jaw after tooth extraction in osteoporotic patients on oral bisphosphonates
정호걸, 황재준, 이정희, 김용현, 나지연, 한상선,
소속 상세정보
정호걸 ( Jeong Ho-Gul ) - Yonsei University College of Dentistry Department of Oral and Maxillofacial Radiology
황재준 ( Hwang Jae-Joon ) - Yonsei University College of Dentistry Department of Oral and Maxillofacial Radiology
이정희 ( Lee Jeong-Hee ) - Yonsei University College of Dentistry Department of Oral and Maxillofacial Radiology
김용현 ( Kim Young-Hyun ) - Yonsei University College of Dentistry Department of Oral and Maxillofacial Radiology
나지연 ( Na Ji-Yeon ) - Yonsei University College of Dentistry Department of Oral and Maxillofacial Radiology
한상선 ( Han Sang-Sun ) - Yonsei University College of Dentistry Department of Oral and Maxillofacial Radiology
Abstract
Purpose: The aim of this study was to investigate the incidence of bisphosphonate-related osteonecrosis of the jaw (BRONJ) after tooth extraction in patients with osteoporosis on oral bisphosphonates in Korea and to evaluate local factors affecting the development of BRONJ.
Materials and Methods: The clinical records of 320 patients who underwent dental extraction while receiving oral bisphosphonates were reviewed. All patients had a healing period of more than 6 months following the extractions. Each patient’s clinical record was used to assess the incidence of BRONJ; if BRONJ occurred, a further radiographic investigation was carried out to obtain a more definitive diagnosis. Various local factors including age, gender, extraction site, drug type, duration of administration, and C-terminal telopeptide (CTx) level were retrieved from the patients’ clinical records for evaluating their effect on the incidence of BRONJ.
Results: Among the 320 osteoporotic patients who underwent tooth extraction, 11 developed BRONJ, reflecting an incidence rate of 3.44%. Out of the local factors that may affect the incidence of BRONJ, gender, drug type, and CTx level showed no statistically significant effects, while statistically significant associations were found for age, extraction site, and duration of administration. The incidence of BRONJ increased with age, was greater in the mandible than the maxilla, and was associated with a duration of administration of more than 3 years.
Conclusion: Tooth extraction in patients on oral bisphosphonates requires careful consideration of their age, the extraction site, and the duration of administration, and close postoperative follow-up should be carried out to facilitate effective early management.
키워드
Bisphosphonate-Associated Osteonecrosis of the Jaw; Osteoporosis; Tooth Extraction; Risk Factors
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