A clinical retrospective study of implant as a risk factor for medication‑related osteonecrosis of the jaw: surgery vs loading?
10.1186/s40902-023-00398-2
- Author:
Yong‑Dae KWON
1
;
Hyunmi JO
;
Jae‑Eun KIM
;
Joo‑Young OHE
Author Information
1. Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyung Hee University, Seoul, South Korea
- Publication Type:RESEARCH
- From:Maxillofacial Plastic and Reconstructive Surgery
2023;45(1):31-
- CountryRepublic of Korea
- Language:English
-
Abstract:
Background:Risk factors for developing medication-related osteonecrosis of the jaw (MRONJ) include the gen‑ eral condition of the patient, smoking habit, poor oral hygiene, and the type, duration, and administration route of the drug, dentoalveolar surgery, such as implant placement. This study aimed to discuss whether implants may induce osteonecrosis in older patients receiving long-term medication and to analyze the radiological pattern of the bone necrosis.
Methods:This study included 33 patients diagnosed with dental implant-associated medication-related osteonecro‑ sis of the jaw. Data regarding the medical history, type of medication used, durations of administration, laboratory test results, onset of bone necrosis since implant placement, type of opposing teeth, and radiological pattern of the bone necrosis on cone-beam computed tomography were recorded in patients with and without implants.
Results:The most commonly used drug was bisphosphonate, with an average duration of use of 61.37 (± 53.72) months. The laboratory results showed average serum C-terminal cross-linking telopeptide (CTX) level of 0.23 ng/ mL, vitamin D, 23.42 ng/mL, and osteocalcin, 4.92 ng/mL. Osteonecrosis occurred after an average of 51.03 (± 39.75) months following implant placement. Radiological evaluation revealed obvious sequestration in the implant-absent group, and the formation of a unit sequestration with an implant fixture (en bloc) was observed in the implant-pre‑ sent group. The patients underwent surgical treatment of sequestrectomy and explantation.
Conclusion:Implant placement, especially loading, may be considered a potential risk factor for the development of osteonecrosis in patients undergoing antiresorptive treatment.
