A case cohort study of the prevention of osteonecrosis of the jaws (ONJ) in bisphosphonate patients requiring dental extractions

Objective: Bisphosphonates related osteonecrosis (BRONJ) has become an increasingly important clinical entity since it has been reported. Once established, it has a detrimental impact on patient’s physical health and also quality of life. The Adelaide Oral and Maxillofacial Surgery Unit uses CTX (Beta cross Laps) test, preoperative antibiotic prophylaxis and post-operative chlorhexidine mouthrinse for all patients. The study is to assess the preventive protocol that has been adopted in a tertiary referral hospital and report the clinical outcome of patients who were on bisphosphonates and require dental extraction.

Method: Patients with history of bisphosphonate uses who were referred to Oral and Maxillofacial Surgery Unit, Royal Adelaide Hospital for management of dental extraction from 2006 to 2010 were included in this retrospective study. Patient’s demographic profile, history of bisphosphonate uses, detail of surgical procedure, and clinical outcome were collected and analysed.

Results: Over 600 consecutive patients were included in this study. The clinical data, outcome and the rate of BRONJ will be presented. The efficacy of using pre-operative fasted CTX testing and pre-operative antibiotic prophylaxis will be presented and discussed.

Conclusion: The preventative protocol in managing patients on bisphosphonates is an important step in preventing BRONJ. Failure of the preventive protocol either by its application or its effect will be assessed for case of delayed healing or full bisphosphonate related osteonecrosis of the jaws (BRONJ).

Conflict of interest: None declared.

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Jan 27, 2018 | Posted by in Oral and Maxillofacial Surgery | Comments Off on A case cohort study of the prevention of osteonecrosis of the jaws (ONJ) in bisphosphonate patients requiring dental extractions
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