Related Experiment Videos
Tooth extraction in osteoporotic patients taking oral bisphosphonates
M Mozzati1, V Arata, G Gallesio
1Private Institute for Oral Surgery and Implantology, Turin 10126, Italy. marcomozzati@libero.it
Summary
Dental extraction is safe for patients on oral bisphosphonates (BPs), with no observed complications or bisphosphonate-associated osteonecrosis of the jaw. Both surgical protocols yielded successful outcomes, suggesting extraction is a safe procedure for this patient group.
Area of Science:
- Oral surgery
- Pharmacology
- Osteoporosis management
Background:
- Oral bisphosphonates (BPs) are widely used for osteoporosis and bone diseases.
- Bisphosphonate-related osteonecrosis of the jaw (BRONJ) has been linked to dental procedures, including extractions.
- Existing literature suggests a correlation between BRONJ and dental pathologies or surgical interventions.
Purpose of the Study:
- To compare the safety and efficacy of two distinct surgical protocols for tooth extraction in patients receiving oral bisphosphonates.
- To evaluate the incidence of bisphosphonate-associated osteonecrosis of the jaw (BRONJ) following dental extractions under different surgical approaches.
- To determine the predictability of treatment outcomes for dental extractions in patients on oral bisphosphonates.
Main Methods:
- A prospective study involving 700 patients undergoing 1,480 dental extractions.
- Patients were randomly assigned to two groups: Protocol A (delicate surgery, primary closure) or Protocol B (nontraumatic avulsion, secondary closure).
- All patients received antibiotic prophylaxis, and follow-up assessments were conducted to monitor for complications.
Main Results:
- No intraoperative complications were reported in either surgical group.
- No cases of bisphosphonate-associated osteonecrosis of the jaw (BRONJ) were observed postoperatively in any of the 1,480 extractions.
- Both Protocol A and Protocol B demonstrated a 100% success rate in predictable treatment outcomes.
Conclusions:
- Dental extraction is a safe procedure for patients treated with oral bisphosphonates.
- Both evaluated surgical protocols are effective, with no significant difference in complication rates.
- Protocol B, involving atraumatic surgery and secondary closure, is recommended for enhanced patient comfort due to minimized tissue trauma.
Related Concept Videos
01:31Osteoclasts in Bone Remodeling
Osteoclasts are cells responsible for bone resorption and remodeling. They originate from hematopoietic progenitor cells present in the bone marrow. Numerous progenitor cells fuse to form multinucleated cells, each with 10-20 nuclei. A single osteoclast has a diameter of 150 to 200 µM. These cells have ruffled borders that break down the underlying bone tissue and release minerals such as calcium into the blood in bone resorption. Osteoclasts cling to bones with their ruffled edges during bone...
01:29Bone Disorders
Aging and its effect on bone remodeling is the most common cause of bone disorders. In young and healthy people, bone deposition and resorption happen at an equal rate to maintain optimal bone health.
Bone deposition is also affected by the levels of sex hormones like estrogen and testosterone that promote osteoblast activity and bone matrix synthesis. When the level of these hormones decreases due to aging, it causes a reduction in bone deposition. As a result, bone resorption by osteoclasts...
Bone deposition is also affected by the levels of sex hormones like estrogen and testosterone that promote osteoblast activity and bone matrix synthesis. When the level of these hormones decreases due to aging, it causes a reduction in bone deposition. As a result, bone resorption by osteoclasts...
01:15Teeth
The formation of teeth, also known as odontogenesis, is a complex process that begins in utero, around the sixth week of embryonic development. There are three stages to this process: the bud stage, the cap stage, and the bell stage.
In the bud stage, the tooth germ (an aggregation of cells) starts to form in the developing jawbone. During the cap stage, the tooth germ differentiates into enamel organ, dental papilla, and dental sac, which will later develop into the tooth's enamel, dentin and...
In the bud stage, the tooth germ (an aggregation of cells) starts to form in the developing jawbone. During the cap stage, the tooth germ differentiates into enamel organ, dental papilla, and dental sac, which will later develop into the tooth's enamel, dentin and...
01:26Tonsillitis II: Management
This lesson will focus on the different treatment options for managing tonsillitis, which typically depend on the cause and severity.
01:31Essential Minerals for Bone Health
The minerals contained in all of the food we consume are essential for our organ systems. However, certain essential minerals, such as calcium, phosphorus, magnesium, manganese, and fluoride, largely affect bone health.
Calcium and Phosphorus
Calcium is a critical component of bones, especially in the form of calcium phosphate and calcium carbonate. Since the body cannot make calcium, it must be obtained from the diet. However, calcium cannot be absorbed from the small intestine without...
Calcium and Phosphorus
Calcium is a critical component of bones, especially in the form of calcium phosphate and calcium carbonate. Since the body cannot make calcium, it must be obtained from the diet. However, calcium cannot be absorbed from the small intestine without...