Abstract:

Bisphosphonate-associated osteonecrosis of the jaw (BAONJ) is a serious adverse reaction to the administration of drugs from the bisphosphonate group. It is a potentially painful and debilitating condition that can significantly affect patients’ quality of life. Although the etiology and pathogenesis of the disease are still not fully understood, in the literature dentoalveolar surgical intervention is indicated as one of the main factors for its occurrence.

The aim of our study was to evaluate the outcome of tooth extraction in patients receiving bisphosphonate treatment, in a quadrant of the jaw without necrosis, investigating the risk factors for the development of the disease, following a clearly defined surgical protocol.

The study included 30 patients undergoing therapy with bisphosphonates (oral or intravenous), with indications for extraction of one or more teeth.

A total of 81 teeth were extracted applying a specific surgical protocol and an antibiotic prophylaxis. As a result, we found a relatively low incidence of BAONJ -it developed in 2 (6.7%) of our examined patients and 3 (3.8%) of our extracted teeth.

In conclusion, we can say that the combination of perioperative antibiotic prophylaxis, atraumatic surgical intervention, smoothing of sharp bone edges and closure of the extraction wound offers a safe and reliable strategy for tooth extraction in patients receiving oral and intravenous bisphosphonate treatment. Due to the limited sample size, however, to draw definitive conclusions regarding the role of various potential risk factors considered in the literature, further studies that include a larger number of patients will be needed.

Keywords: Bisphosphonate-associated osteonecrosis of the jaw (BAONJ), risk factors, tooth extraction