Dentoalveolar surgeryPreventive Protocol for Tooth Extractions in Patients Treated With Zoledronate: A Case Series
Section snippets
Patients and Methods
From January 2007 to December 2008, a total of 114 patients, treated with zoledronate (4-mg intravenous infusion every 3 to 4 weeks), were referred to our Center for Research, Prevention and Care of BRONJ, First Section of Dentistry, University of Catania.
The following patient parameters were collected: age, primary systemic pathologic features, duration of zoledronate administration, eventual suspension of zoledronate, and oral pathologic findings.
The ethical committee of our university
Results
The average patient age was 56.4 ± 5.8 years. The average duration of zoledronate administration was 16.2 ± 3.2 months (Table 1). A total of 102 dental extractions in 43 patients were performed using the proposed preventive protocol (Table 2). During the 12-month follow-up period, no signs of inflamed tissue or necrotic exposed bone were observed in any patient.
No radiographic signs of BRONJ were observed on the orthopantomograms 12 months after the surgical procedures.
Discussion
BRONJ, a rare condition characterized by exposed necrotic bone in the maxillofacial region of patients treated with BPs, has received increasing attention since the early reports published in 2003.3, 7
Most of the recent publications have suggested that dental treatment of BP-treated patients should be conservative. Restorative dentistry, limited nonoperative periodontics, and endodontics have been the methods of choice in such patients. According to the American Association of Oral and
References (18)
Pamidronate (Aredia) and zoledronate (Zometa) induced avascular necrosis of the jaws: A growing epidemic
J Oral Maxillofac Surg
(2003)- et al.
Osteonecrosis of the jaws associated with the use of bisphosphonates: A review of 63 cases
J Oral Maxillofac Surg
(2004) - et al.
Comprehensive review of bisphosphonate therapy: Implications for the oral and maxillofacial surgery patient
J Oral Maxillofac Surg
(2009) - et al.
Oral bisphosphonates induced osteonecrosis: Risk factors, prediction of risk using serum CTX testing, prevention, and treatment
J Oral Maxillofac Surg
(2007) - et al.
The pathogenesis of bisphosphonate-related osteonecrosis of the jaw: So many hypotheses, so few data
J Oral Maxillofac Surg
(2009) - et al.
Position paper on bisphosphonate-related osteonecrosis of the jaws—2009 update
J Oral Maxillofac Surg
(2009) - et al.
Atraumatic teeth extraction in bisphosphonate treated patients
J Oral Maxillofac Surg
(2008) - et al.
Bisphosphonate-related osteonecrosis of the jaw (BRONJ): Run dental management designs and issues in diagnosis
Ann Oncol
(2007) - et al.
Prevalence of osteonecrosis of the jaw in patients with oral bisphosphonate exposure
Oral J Maxillofac Surg
(2010)