TY - JOUR
T1 - Osteonecrosis of the Jaw and Dental Extractions: A Single-Center Experience.
AU - Villa, Alessandro
AU - Sandhu, S.
AU - Salous, M. H.
AU - Sankar, V.
AU - Margalit, Danielle N.
N1 - 1 Division of Oral Medicine and Dentistry, Brigham and Women's Hospital/Dana Farber Cancer Institute, Harvard School of Dental Medicine, Boston, MA, USA. Electronic address: [email protected]. 2 Division of Oral Medicine and Dentistry, Brigham and Women's Hospital/Dana Farber Cancer Institute, Harvard School of Dental Medicine.
PY - 2020/11
Y1 - 2020/11
N2 - Objective: The aim of this study was to investigate the frequency of osteoradionecrosis/medication-related osteonecrosis of the jaw (ORN/MRONJ) after dental extraction with use of postextraction antibiotic coverage without prophylactic hyperbaric oxygen (HBO) in patients who received radiotherapy to head and neck (RT-HN) or antiresorptive medications and to determine possible associated factors. Study design: A retrospective study was conducted in patients who had a history of RT-HN or exposure to antiresorptives and who underwent dental extractions from 2003 to 2019. According to the clinical protocol, patients received amoxicillin 500 mg, 3 times daily (TID) for at least 14 days, and chlorhexidine 0.12% rinses, 2 times daily (BID), after extraction (or an alternative antibiotic if allergic to amoxicillin). HBO was not used for patients with RT-HN. Results: Ninety patients underwent a total of 243 extractions. Fifty patients (55.5%) received a median of 54.1 Gray to the extraction site and 40 (44.4%) were on antiresorptives. None of the patients received both RT and antiresorptives. Of 40 patients, 3 (7.5%) developed MRONJ, and of 50 patients, 1 (2%) developed ORN. Among those at risk for MRONJ, male gender and concomitant immunosuppressant medications were associated with MRONJ development (P < .05). Conclusions: In our patient cohort, the rate of postextraction ORN/MRONJ was lower and comparable with the rates reported in the literature. Larger prospective studies are required to validate the efficacy of postextraction antibiotics in reducing ONJ.
AB - Objective: The aim of this study was to investigate the frequency of osteoradionecrosis/medication-related osteonecrosis of the jaw (ORN/MRONJ) after dental extraction with use of postextraction antibiotic coverage without prophylactic hyperbaric oxygen (HBO) in patients who received radiotherapy to head and neck (RT-HN) or antiresorptive medications and to determine possible associated factors. Study design: A retrospective study was conducted in patients who had a history of RT-HN or exposure to antiresorptives and who underwent dental extractions from 2003 to 2019. According to the clinical protocol, patients received amoxicillin 500 mg, 3 times daily (TID) for at least 14 days, and chlorhexidine 0.12% rinses, 2 times daily (BID), after extraction (or an alternative antibiotic if allergic to amoxicillin). HBO was not used for patients with RT-HN. Results: Ninety patients underwent a total of 243 extractions. Fifty patients (55.5%) received a median of 54.1 Gray to the extraction site and 40 (44.4%) were on antiresorptives. None of the patients received both RT and antiresorptives. Of 40 patients, 3 (7.5%) developed MRONJ, and of 50 patients, 1 (2%) developed ORN. Among those at risk for MRONJ, male gender and concomitant immunosuppressant medications were associated with MRONJ development (P < .05). Conclusions: In our patient cohort, the rate of postextraction ORN/MRONJ was lower and comparable with the rates reported in the literature. Larger prospective studies are required to validate the efficacy of postextraction antibiotics in reducing ONJ.
KW - Dental Extractions
KW - Jaw
KW - Osteonecrosis
UR - https://pubmed.ncbi.nlm.nih.gov/32723683/
U2 - 10.1016/j.oooo.2020.07.001
DO - 10.1016/j.oooo.2020.07.001
M3 - Article
VL - 130
JO - Oral Surgery, Oral Medicine, Oral Pathology, and Oral Radiology
JF - Oral Surgery, Oral Medicine, Oral Pathology, and Oral Radiology
ER -