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Risk factors of osteonecrosis of the jaw after tooth extraction in osteoporotic patients on oral bisphosphonates

 Ho-Gul Jeong  ;  Jae Joon Hwang  ;  Jeong-Hee Lee  ;  Young Hyun Kim  ;  Ji Yeon Na  ;  Sang-Sun Han 
 IMAGING SCIENCE IN DENTISTRY, Vol.47(1) : 45-50, 2017 
Journal Title
Issue Date
Bisphosphonate-Associated Osteonecrosis of the Jaw ; Osteoporosis ; Risk Factors ; Tooth Extraction
PURPOSE: The aim of this study was to investigate the incidence of bisphosphonate-related osteonecrosis of the jaw (BRONJ) after tooth extraction in patients with osteoporosis on oral bisphosphonates in Korea and to evaluate local factors affecting the development of BRONJ. MATERIALS AND METHODS: The clinical records of 320 patients who underwent dental extraction while receiving oral bisphosphonates were reviewed. All patients had a healing period of more than 6 months following the extractions. Each patient's clinical record was used to assess the incidence of BRONJ; if BRONJ occurred, a further radiographic investigation was carried out to obtain a more definitive diagnosis. Various local factors including age, gender, extraction site, drug type, duration of administration, and C-terminal telopeptide (CTx) level were retrieved from the patients' clinical records for evaluating their effect on the incidence of BRONJ. RESULTS: Among the 320 osteoporotic patients who underwent tooth extraction, 11 developed BRONJ, reflecting an incidence rate of 3.44%. Out of the local factors that may affect the incidence of BRONJ, gender, drug type, and CTx level showed no statistically significant effects, while statistically significant associations were found for age, extraction site, and duration of administration. The incidence of BRONJ increased with age, was greater in the mandible than the maxilla, and was associated with a duration of administration of more than 3 years. CONCLUSION: Tooth extraction in patients on oral bisphosphonates requires careful consideration of their age, the extraction site, and the duration of administration, and close postoperative follow-up should be carried out to facilitate effective early management.
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2. College of Dentistry (치과대학) > Dept. of Oral and Maxillofacial Radiology (영상치의학교실) > 1. Journal Papers
Yonsei Authors
Na, Ji Yeon(나지연)
Jeong, Ho Gul(정호걸)
Han, Sang Sun(한상선) ORCID logo https://orcid.org/0000-0003-1775-7862
Hwang, Jae Joon(황재준)
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