When not to go for tooth extraction in people on bisphosphonates – A prospective clinical study.
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2018, Vol 17, Issue 5
Abstract
Invasive dental procedures including tooth extraction are considered one of the most crucial risk factors for Bisphosphonate related osteonecrosis of the jaw (BRONJ). But sometimes the tooth cannot be salvaged due to poor prognosis. Ultimately the practitioner is in a dilemma whether to go for extraction or not. A lot of literature has been written about the methods to minimize the risk of developing BRONJ in an extraction patient. But very limited studies are there to stratify which patients can land in a complication. This study is based on 29 patients undergoing 45 extractions using different bisphosphonates for various medical conditions. In all patients, extraction sockets showed wound closure without bone exposure within minimum 4 weeks, followed by normal epithelization within 6 weeks after extraction except for 2 cases in which established BRONJ developed. However, 4 patients showed delayed healing with bone exposure in sockets even 8 weeks after extraction ultimately with proper soft tissue coverage. One observation could be made that all the established BRONJ cases or delayed healing were those with multiple myeloma and steroid intake with IV zolendronate as the BP used. The delayed healing cases where also those of IV zolendronate and multiple myeloma cases. This study though small concluded that primary bone disease are at increased risk for developing BRONJ than bone metastasis.
Authors and Affiliations
Shahi Jahan, Ashiq Ali, Ajaz A Shah, Bushra Rehman, Muneet Kapoor, Syed Wakeel
Keywords
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- EP ID EP374678
- DOI 10.9790/0853-1705074144.
- Views 55
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