The observational study of delayed wound healing after tooth extraction in patients receiving oral bisphosphonate therapy

• Published in: Journal of cranio-maxillo-facial surgery Vol. 41; no. 7; pp. 558 - 563
• Main Authors: Hasegawa, Takumi, Ri, Shinshou, Umeda, Masahiro, Komatsubara, Hideki, Kobayashi, Masaki, Shigeta, Takashi, Yoshitomi, Izumi, Ikeda, Hisazumi, Shibuya, Yasuyuki, Asahina, Izumi, Komori, Takahide
• Format: Journal Article
• Language: English
• Published: Scotland Elsevier Ltd 01-10-2013
• Subjects: Administration, Oral; Adult; Aged; Aged, 80 and over; Alendronate - administration & dosage; Antibiotic Prophylaxis; Bisphosphonate; Bisphosphonate related osteonecrosis of jaw; Bisphosphonate-Associated Osteonecrosis of the Jaw - prevention & control; Bone Density Conservation Agents - administration & dosage; Dental Caries - surgery; Dentistry; Diphosphonates - administration & dosage; Etidronic Acid - administration & dosage; Etidronic Acid - analogs & derivatives; Female; Humans; Male; Middle Aged; Oral bisphosphonate; Oral Fistula - etiology; Periapical Periodontitis - surgery; Periodontitis - surgery; Risedronate Sodium; Risk Factors; Surgery; Time Factors; Tooth extraction; Tooth Extraction - methods; Wound Healing - drug effects; Tooth extraction; Bisphosphonate; Bisphosphonate related osteonecrosis of jaw; Oral bisphosphonate
• ISSN: 1010-5182; 1878-4119
• DOI: 10.1016/j.jcms.2012.11.023

Abstract Introduction In this study, we investigated whether such a discontinuation of oral bisphosphonate (BP) for 3 months might influence the incidence of BP-related osteonecrosis of the jaw (BRONJ) and wound healing after tooth extraction in patients receiving oral BP therapy. Material and methods There were a total of 434 teeth in 201 patients (18 males and 183 females). The patients were divided into two groups depending on whether or not they underwent a 3-month discontinuation of BP therapy (BP− and BP+) before tooth extraction. In this observational study investigated delayed wound healing after tooth extraction in patients receiving oral BP therapy. Results In all cases of the BP− group, there were no BRONJ although there was delayed wound healing in two cases. However, in one case of the BP+ group, oral BP was continued because it was deemed high risk to discontinue treatment by the patient's physician. In this case, an intraoral fistula was still present with bone exposure at 120 weeks after extraction (BRONJ stage 1). Conclusion This study supports the idea of a drug holiday and encourages further clinical research on this topic of tooth extraction in patients receiving oral BP therapy.