Osteonecrosis of the jaws in patients under osteoporosis treatment: a nine-year experience report

Abstract

Objective: This study aimed to report the experience of medication-related osteonecrosis of the jaws (MRONJ) in osteoporotic patients for nine years, and their associated initiating factors. Materials and methods: The numbers of invasive oral procedures (IOP) (tooth extraction, dental implant placement, and periodontal procedures) and removable prostheses performed from January 2012 to January 2021 were obtained from the digital records of a large public dental center. There were an estimated 6,742 procedures performed in patients under osteoporosis treatment. Results: Two cases (0.03%) of MRONJ were registered in nine years amongst patients with osteoporosis who had dental treatment at the center. From the 1,568 tooth extractions, one patient (0.06%) developed MRONJ. There was also one case from the 2,139 removable prostheses delivered (0.05%). Conclusions:The prevalence of MRONJ associated with osteoporosis treatment was very low. The protocols adopted seem to be adequate for the prevention of this complication. The findings of this study reinforce the rare frequency of MRONJ associated with dental procedures in patients submitted to the pharmacological management of osteoporosis. An integral analysis of systemic risk factors and oral preventive strategies may be considered regularly in the dental treatment of these patients.

Response to the letter to the editor: Osteonecrosis of the jaws in patients under osteoporosis treatment: nine-year experience report

“…We would like to thank Dr. Efsun Somay for the comments concerning our study ( 1 ), which will permit us to clarify some critical points.…”

Osteonecrosis of the jaws in patients under osteoporosis treatment: a nine-year experience report

“…The scholarly work titled "Osteonecrosis of the jaws in patients under osteoporosis treatment: a nine-year experience report" authored by Penoni and cols. ( 1 ) was perused with keen interest. The authors are to be commended for their investigation of a seldom-discussed yet consequential complication that adversely impacts patients’ well-being.…”

“…Unfortunately, Penoni and cols. ( 1 ) did not provide the window period between implant placement and prosthetic loading. Because prosthetic loading constitutes an integral aspect of implant therapy, it may be worthwhile to conduct a distinct analysis of MRONJ incidence rates after implant placement and the prosthetic phase.…”