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

J Craniomaxillofac Surg. 2013 Oct;41(7):558-63. doi: 10.1016/j.jcms.2012.11.023. Epub 2013 Jan 16.

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.

Keywords: Bisphosphonate; Bisphosphonate related osteonecrosis of jaw; Oral bisphosphonate; Tooth extraction.

Publication types

  • Observational Study

MeSH terms

  • Administration, Oral
  • Adult
  • Aged
  • Aged, 80 and over
  • Alendronate / administration & dosage
  • Antibiotic Prophylaxis
  • Bisphosphonate-Associated Osteonecrosis of the Jaw / prevention & control
  • Bone Density Conservation Agents / administration & dosage*
  • Dental Caries / surgery
  • Diphosphonates / administration & dosage*
  • Etidronic Acid / administration & dosage
  • Etidronic Acid / analogs & derivatives
  • Female
  • Humans
  • Male
  • Middle Aged
  • Oral Fistula / etiology
  • Periapical Periodontitis / surgery
  • Periodontitis / surgery
  • Risedronic Acid
  • Risk Factors
  • Time Factors
  • Tooth Extraction* / methods
  • Wound Healing / drug effects

Substances

  • Bone Density Conservation Agents
  • Diphosphonates
  • Risedronic Acid
  • Etidronic Acid
  • Alendronate