Long waiting time before tooth extraction may increase delayed wound healing in elderly Japanese

Area of Science:

• Gerontology
• Oral and Maxillofacial Surgery
• Pharmacology

Background:

• Osteoporosis patients on antiresorptive medications face a risk of osteonecrosis of the jaw (ONJ).
• Concerns about ONJ have led to recommendations to delay tooth extractions for these patients.
• The potential impact of delayed extraction on wound healing has not been fully elucidated.

Purpose of the Study:

• To investigate the association between prolonged waiting times for tooth extraction and delayed wound healing in patients aged 60 and older.
• To determine if delayed wound healing beyond 8 weeks is a risk factor for ONJ in this demographic.

Main Methods:

• A cross-sectional study involving 426 patients (aged 60-96) who underwent tooth extraction.
• Data collected via structured questionnaires, including self-reported kyphosis as a marker for vertebral fractures.
• Logistic regression analysis used to assess the risk of delayed wound healing based on extraction waiting time.

Main Results:

• Patients waiting over two months for tooth extraction had a significantly higher risk of delayed wound healing (OR=7.23) compared to those extracted within one month.
• This increased risk was observed irrespective of antiresorptive medication use.
• Self-reported kyphosis was also significantly associated with an increased risk of delayed wound healing (OR=5.08).

Conclusions:

• Prolonged waiting times for tooth extraction (over two months) may be a significant risk factor for delayed wound healing in patients aged 60 and older.
• Delayed wound healing is a potential precursor to osteonecrosis of the jaw (ONJ).
• These findings suggest a need to re-evaluate current guidelines regarding tooth extraction timing for elderly patients, particularly those with osteoporosis.