Dental implants as risk factors for patients with medication-related osteonecrosis of the jaws (MRONJ). 2020

S E C Pichardo, and J G van der Hee, and M Fiocco, and N M Appelman-Dijkstra, and J P R van Merkesteyn
Department of Oral & Maxillofacial Surgery (Chair: Prof. Dr. JPR van Merkesteyn), Leiden University Medical Center, PO BOX 9600, 2300 RC Leiden, The Netherlands; Center for Bone Quality Leiden, Leiden University Medical Center, PO BOX 9600, 2300 RC Leiden, The Netherlands.

An increasing number of patients with medication-related osteonecrosis of the jaws (MRONJ) has recently been reported. It is still being debated whether the presence or placement of dental implants can lead to MRONJ, so the aim of this study was to find out whether dental implants are a risk factor for MRONJ. From January 2003-January 2019 180 patients with MRONJ were seen at the Leiden University Medical Center. Luxating moments for the onset of MRONJ were calculated retrospectively. We collected clinical data and details of antiresorptive medication and found 22 patients with both dental implants and MRONJ. In 18 patients the implants were in the region of the MRONJ and they were included in this study, 14 who had had implants before using antiresorptive drugs and four who had had antiresorptive drugs before or at the time that the implants were placed. The median times between the placement of implants and the diagnosis of MRONJ in these two groups were 24 months and 6 months, respectively. Among the 47 implants, 30 were located in the necrotic region, and all 30 were either lost spontaneously or had to be removed during treatment of MRONJ. Our results show an increased risk for developing MRONJ in patients with dental implants. Both peri-implantitis around previously placed implants, and insertion of dental implants, are risk factors. Prevention of peri-implantitis and caution when inserting dental implants in patients who take antiresorptive medication are therefore important.

UI MeSH Term Description Entries
D004164 Diphosphonates Organic compounds which contain P-C-P bonds, where P stands for phosphonates or phosphonic acids. These compounds affect calcium metabolism. They inhibit ectopic calcification and slow down bone resorption and bone turnover. Technetium complexes of diphosphonates have been used successfully as bone scanning agents. Bisphosphonate,Bisphosphonates
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D012189 Retrospective Studies Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons. Retrospective Study,Studies, Retrospective,Study, Retrospective
D012307 Risk Factors An aspect of personal behavior or lifestyle, environmental exposure, inborn or inherited characteristic, which, based on epidemiological evidence, is known to be associated with a health-related condition considered important to prevent. Health Correlates,Risk Factor Scores,Risk Scores,Social Risk Factors,Population at Risk,Populations at Risk,Correlates, Health,Factor, Risk,Factor, Social Risk,Factors, Social Risk,Risk Factor,Risk Factor Score,Risk Factor, Social,Risk Factors, Social,Risk Score,Score, Risk,Score, Risk Factor,Social Risk Factor
D015921 Dental Implants Biocompatible materials placed into (endosseous) or onto (subperiosteal) the jawbone to support a crown, bridge, or artificial tooth, or to stabilize a diseased tooth. Dental Implants, Mini,Dental Prosthesis, Surgical,Implants, Dental,Dental Implant,Dental Prostheses, Surgical,Implant, Dental,Prostheses, Surgical Dental,Prosthesis, Surgical Dental,Surgical Dental Prostheses,Surgical Dental Prosthesis,Dental Implant, Mini,Mini Dental Implant,Mini Dental Implants
D050071 Bone Density Conservation Agents Agents that inhibit BONE RESORPTION and/or favor BONE MINERALIZATION and BONE REGENERATION. They are used to heal BONE FRACTURES and to treat METABOLIC BONE DISEASES such as OSTEOPOROSIS. Antiresorptive Agent,Antiresorptive Agents,Antiresorptive Drugs,Bone Resorption Inhibitors,Bone Resorption Inhibitory Agents,Agent, Antiresorptive,Inhibitors, Bone Resorption,Resorption Inhibitors, Bone
D059266 Bisphosphonate-Associated Osteonecrosis of the Jaw Necrotic jaws or other maxillofacial skeleton necrosis associated with bisphosphonate use (see BISPHOSPHONATES). Injury, dental procedures, and trauma can trigger the necrotic process. Bisphosphonate Osteonecrosis,Bisphosphonate-Associated Osteonecrosis,Bisphosphonate-Associated Osteonecrosis of the Jaws,Bisphosphonate-Induced Osteonecrosis of the Jaw,Bisphosphonate-Induced Osteonecrosis of the Jaws,Bisphosphonate-Related Osteonecrosis of the Jaw,Osteonecrosis of the Jaw, Bisphosphonate-Associated,Osteonecrosis of the Jaw, Bisphosphonate-Induced,Osteonecrosis of the Jaw, Bisphosphonate-Related,Osteonecrosis of the Jaws, Bisphosphonate-Associated,Osteonecrosis of the Jaws, Bisphosphonate-Induced,Osteonecrosis of the Jaws, Bisphosphonate-Related,Bisphosphonate Associated Osteonecrosis,Bisphosphonate Associated Osteonecrosis of the Jaw,Bisphosphonate Associated Osteonecrosis of the Jaws,Bisphosphonate Induced Osteonecrosis of the Jaw,Bisphosphonate Induced Osteonecrosis of the Jaws,Bisphosphonate Osteonecroses,Bisphosphonate Related Osteonecrosis of the Jaw,Bisphosphonate-Associated Osteonecroses,Osteonecroses, Bisphosphonate,Osteonecroses, Bisphosphonate-Associated,Osteonecrosis of the Jaw, Bisphosphonate Associated,Osteonecrosis of the Jaw, Bisphosphonate Induced,Osteonecrosis of the Jaw, Bisphosphonate Related,Osteonecrosis of the Jaws, Bisphosphonate Associated,Osteonecrosis of the Jaws, Bisphosphonate Induced,Osteonecrosis of the Jaws, Bisphosphonate Related,Osteonecrosis, Bisphosphonate,Osteonecrosis, Bisphosphonate-Associated

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