Assessing the association between bisphosphonate exposure and delayed mucosal healing after tooth extraction

Cesar A. Migliorati, Deborah Saunders, Michael S. Conlon, Hanne Kleven Ingstad, Paul Vaagen, Mitzi J. Palazzolo, Bente B. Herlofson

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Background: Tooth extraction in patients exposed to bisphosphonates (BPs) is considered a risk factor for osteonecrosis. The authors evaluated the time to mucosal healing and frequency of osteonecrosis after tooth extraction in participants exposed to BPs. Methods: The authors compared wound healing after tooth extraction in participants exposed to BPs with that in control participants who had not been exposed to BPs. Variables included age, sex, type of BP therapy (oral or intravenous), BP exposure time and C-terminal telopeptide (CTX) test results. The authors followed up patients weekly or biweekly until healing was complete. They used multivariable analyses to model time to healing in the presence of covariates, and estimates provided hazard ratios (HRs) and 95 percent confidence intervals (CIs) adjusted for all variables in the model. Results: The authors enrolled 53 participants with BP exposure and 39 control participants. Postextraction healing was significantly longer in participants exposed to BPs (P < .001) than it was in control participants. One patient (1.9 percent) developed osteonecrosis. A Cox proportional hazards model in which the authors controlled for age, sex and CTX values showed that BP exposure alone significantly (HR, 0.30; 95 percent confidence interval, 0.17-0.51) increased mucosal healing time. Conclusions: The study results showed that postextraction healing was impaired in patients exposed to BPs. CTX values were not associated with delayed healing after tooth extraction. Practical Implications: Postextraction healing was delayed in patients receiving BP therapy. However, the risk of developing osteonecrosis was low.

Original languageEnglish (US)
Pages (from-to)406-414
Number of pages9
JournalJournal of the American Dental Association
Volume144
Issue number4
DOIs
StatePublished - Jan 1 2013

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Tooth Extraction
Diphosphonates
Osteonecrosis
Confidence Intervals
Proportional Hazards Models
Wound Healing

All Science Journal Classification (ASJC) codes

  • Dentistry(all)

Cite this

Migliorati, C. A., Saunders, D., Conlon, M. S., Ingstad, H. K., Vaagen, P., Palazzolo, M. J., & Herlofson, B. B. (2013). Assessing the association between bisphosphonate exposure and delayed mucosal healing after tooth extraction. Journal of the American Dental Association, 144(4), 406-414. https://doi.org/10.14219/jada.archive.2013.0134

Assessing the association between bisphosphonate exposure and delayed mucosal healing after tooth extraction. / Migliorati, Cesar A.; Saunders, Deborah; Conlon, Michael S.; Ingstad, Hanne Kleven; Vaagen, Paul; Palazzolo, Mitzi J.; Herlofson, Bente B.

In: Journal of the American Dental Association, Vol. 144, No. 4, 01.01.2013, p. 406-414.

Research output: Contribution to journalArticle

Migliorati, CA, Saunders, D, Conlon, MS, Ingstad, HK, Vaagen, P, Palazzolo, MJ & Herlofson, BB 2013, 'Assessing the association between bisphosphonate exposure and delayed mucosal healing after tooth extraction', Journal of the American Dental Association, vol. 144, no. 4, pp. 406-414. https://doi.org/10.14219/jada.archive.2013.0134
Migliorati, Cesar A. ; Saunders, Deborah ; Conlon, Michael S. ; Ingstad, Hanne Kleven ; Vaagen, Paul ; Palazzolo, Mitzi J. ; Herlofson, Bente B. / Assessing the association between bisphosphonate exposure and delayed mucosal healing after tooth extraction. In: Journal of the American Dental Association. 2013 ; Vol. 144, No. 4. pp. 406-414.
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