Diabetes Mellitus and Its Association to the Occurrence of Medication-Related Osteonecrosis of the Jaw

Rahimi-Nedjat, Roman Kia; Sagheb, Keyvan; Pabst, Andreas; Olk, Lukas

doi:10.3390/dj4020017

Cited by 15 publications

(12 citation statements)

References 35 publications

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“…Similar observations, however, can also be found in the literature. As well, in a previous study of own, we were able to show that while diabetics have a worsened immune response and therefore are prone to infections, they can have regular wound healing and a normal treatment process with similar inpatient stays if they are under good medicinal or dietary treatment and therefore maintaining normal blood sugar counts [13][14][15][16].…”

Section: Discussionsupporting

confidence: 72%

The role of diabetes mellitus on the formation of severe odontogenic abscesses—a retrospective study

Rahimi-Nedjat

Sagheb

et al. 2021

Clin Oral Invest

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Objectives To analyze the correlation of diabetes mellitus and hyperglycemia with severe odontogenic abscesses. Materials and methods Records of all patients in the Department of Oral and Maxillofacial Surgery of the Medical Center of the Johannes Gutenberg-University who underwent inpatient treatment for severe odontogenic abscesses between 2010 and 2016 were evaluated retrospectively regarding diabetes anamnesis, maximum and fasting blood sugar count, and duration until discharge. In order to compare the numbers to a general maxillofacial group, all patients who received inpatient treatment in 2013 for any diagnosis other than an abscess of the head and neck region were analyzed as well, and the numbers were correlated. Results In total, 977 abscess patients were found in the analyzed period. 7.0% of the patients had a known diagnosis of diabetes mellitus type II and 0.6% of type I. Correlation with the general group showed that abscesses were significantly more likely in diabetics as well as patients with abnormal maximum and fasting blood sugar counts. These patients also needed significantly longer inpatient treatment. Conclusions Diabetics and patients with abnormal glucose tolerance show significantly higher numbers of severe odontogenic abscesses and might therefore benefit from earlier escalation of antibiotic medication. Clinical relevance Severe odontogenic abscesses are one of the most frequent diagnoses in maxillofacial practice. Adjusting the therapeutic approach for diabetics or patients with abnormal blood sugar counts might help to prevent the development of abscesses.

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Section: Discussionsupporting

confidence: 72%

The role of diabetes mellitus on the formation of severe odontogenic abscesses—a retrospective study

Rahimi-Nedjat

Sagheb

et al. 2021

Clin Oral Invest

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“…Bisphosphonates or denosumab have not been found to increase the risk of cardiovascular events so the reasoning behind a lower prescription in patients with these conditions as found in this study is not clear [7,27,28]. Small observational studies have linked diabetes to medication-related jaw osteonecrosis, however this has been refuted in higher quality research [29]. Osteoporosis guidelines should provide clear advice regarding risk-benefit decisions in the presence of medical conditions, providing information on testing required and in which cases referral to specialists are indicated [4].…”

Section: Discussionmentioning

confidence: 85%

Factors associated with initiation of bone-health medication among older adults in primary care in Ireland

Walsh

Nerdrum

Fahey

et al. 2020

Preprint

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Background: Adults at high risk of fragility fracture should be offered pharmacological treatment when not contraindicated, however under-treatment is common. Objective: This study aimed to investigate factors associated with bone-health medication initiation in older patients attending primary care. Design: Retrospective cohort study. Setting: 44 general practices in Ireland from 2011-2017. Subjects: Adults aged ≥65 years who were naive to bone-health medication for 12 months. Methods: Overall fracture-risk (based on QFracture) and individual fracture-risk factors were described for patients initiated and not initiated onto medication and compared using generalised linear model regression with Poisson distribution. Results: Of 36,799 patients (51 % female, mean age 75.4 (SD=8.4)) included, 8% (n=2,992) were observed to initiate on bone-health medication during the study. One fifth of all patients (n=8,193) had osteoporosis or had high fracture-risk but only 21% of them (n=1,687) initiated on medication. Female sex, older age, state-funded health cover and osteoporosis were associated with initiation. Independently of osteoporosis and co-variates, high 5-year QFracture risk for hip (IRR=1.33 (95% CI=1.17-1.50), p<0.01) and all fractures (IRR=1.30 (95% CI=1.17-1.44), p<0.01) were associated with medication initiation. Previous fracture, rheumatoid arthritis, and corticosteroid use were associated with initiation, while liver, kidney, cardiovascular disease, diabetes and oestrogen-only hormone replacement therapy showed an inverse association. Conclusions: Bone-health medication initiation is targeted at patients at higher fracture-risk but much potential under-treatment remains, particularly in those >80 years and with co-morbidities. This may reflect clinical uncertainty in older multimorbid patients, and further research should explore decision-making in preventive bone medication prescribing.

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“…Concomitant medical therapy may enhance ONJ risk, which has been particularly reported for corticosteroids and antiangiogenic therapy. A correlation to chemotherapy, diabetes, or anaemia is less substantiated [ 12 , 20 , 25 , 70 ], although a recently published article sees an association to a pathological glucose metabolism [ 93 ]. Altogether, systemic risk factors seem to have less impact than local variables [ 70 ].…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Medication-Related Osteonecrosis of the Jaw in Patients with Breast Cancer, Prostate Cancer, and Multiple Myeloma

et al. 2016

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Medication-related osteonecrosis of the jaw is a known side-effect of antiresorptive therapy in patients with malignant diseases. Nevertheless, the exact pathogenesis is still unknown and published prevalences show a significant range. The aim of the presented paper was to assess the prevalence of osteonecrosis (ONJ) in breast cancer, prostate cancer, and multiple myeloma patients receiving parenteral antiresorptive therapy. For this reason a PubMed search was performed and 69 matching articles comprising 29,437 patients were included in the analysis. Nine-hundred fifty-one cases of jaw necrosis were described. The overall ONJ-prevalence was 2.09% in the breast cancer group, 3.8% in the prostate cancer group, and 5.16% for multiple myeloma patients.

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Diabetes Mellitus and Its Association to the Occurrence of Medication-Related Osteonecrosis of the Jaw

Cited by 15 publications

References 35 publications

The role of diabetes mellitus on the formation of severe odontogenic abscesses—a retrospective study

The role of diabetes mellitus on the formation of severe odontogenic abscesses—a retrospective study

Factors associated with initiation of bone-health medication among older adults in primary care in Ireland

Prevalence of Medication-Related Osteonecrosis of the Jaw in Patients with Breast Cancer, Prostate Cancer, and Multiple Myeloma

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