Risk assessment and drug interruption guidelines for dentoalveolar surgery in patients with osteoporosis receiving anti-resorptive therapy

IF 3.4 3区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Dental Sciences Pub Date : 2025-02-11 DOI:10.1016/j.jds.2025.02.002

Ling-Ying Wei , Ching-Ming Chiu , Sang-Heng Kok , Hao-Hong Chang , Shih-Jung Cheng , Hung-Ying Lin , Wei-Yih Chiu , Jang-Jaer Lee

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引用次数: 0

Abstract

Medication-related osteonecrosis of the jaw (MRONJ) is a rare and challenging complication of anti-resorptive therapy. This review addresses the critical issue of risk management in patients with osteoporosis who require dentoalveolar surgery while undergoing anti-resorptive therapy. Dental practitioners should be aware of these risks; however, they should not refuse treatment based solely on them. This review discusses the risks through five major factors: invasive dentoalveolar surgeries, concomitant oral infection, type of medication, duration of medication, and preoperative drug discontinuation. Additionally, we discussed the local factors associated with dental practices. Our review underscored the importance of personalized risk assessment, considering each patient's unique drug history and oral condition. Based on a comprehensive literature review and clinical evidence, we proposed specific guidelines for preoperative drug interruption tailored to different anti-resorptive agents. These recommendations aimed to balance osteoporosis management by minimizing the risk of MRONJ during oral surgical interventions and bridging the knowledge gap in managing patients with osteoporosis requiring dental care. This review will allow clinicians to improve their practice and optimize patient outcomes by providing evidence-based strategies.

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接受抗吸收治疗的骨质疏松患者牙槽手术的风险评估和药物中断指南

药物相关性颌骨骨坏死（MRONJ）是一种罕见且具有挑战性的抗吸收治疗并发症。这篇综述讨论了骨质疏松症患者在接受抗吸收治疗时需要牙槽骨手术的风险管理问题。牙科医生应注意这些风险；然而，他们不应该仅仅因为他们自己而拒绝治疗。本文从5个主要因素来探讨其风险：侵袭性牙槽牙外科手术、合并口腔感染、用药类型、用药持续时间和术前停药。此外，我们还讨论了与牙科实践相关的当地因素。我们的综述强调了个性化风险评估的重要性，考虑到每个患者独特的用药史和口腔状况。基于全面的文献回顾和临床证据，我们提出了针对不同抗再吸收药物的术前药物中断的具体指南。这些建议旨在通过在口腔外科干预期间减少MRONJ的风险和弥合需要牙科护理的骨质疏松症患者管理方面的知识差距来平衡骨质疏松症的管理。这篇综述将允许临床医生通过提供循证策略来改进他们的实践和优化患者的结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Dental Sciences 医学-牙科与口腔外科

CiteScore

5.10

自引率

14.30%

发文量

348

审稿时长

6 days

期刊介绍： he Journal of Dental Sciences (JDS), published quarterly, is the official and open access publication of the Association for Dental Sciences of the Republic of China (ADS-ROC). The precedent journal of the JDS is the Chinese Dental Journal (CDJ) which had already been covered by MEDLINE in 1988. As the CDJ continued to prove its importance in the region, the ADS-ROC decided to move to the international community by publishing an English journal. Hence, the birth of the JDS in 2006. The JDS is indexed in the SCI Expanded since 2008. It is also indexed in Scopus, and EMCare, ScienceDirect, SIIC Data Bases. The topics covered by the JDS include all fields of basic and clinical dentistry. Some manuscripts focusing on the study of certain endemic diseases such as dental caries and periodontal diseases in particular regions of any country as well as oral pre-cancers, oral cancers, and oral submucous fibrosis related to betel nut chewing habit are also considered for publication. Besides, the JDS also publishes articles about the efficacy of a new treatment modality on oral verrucous hyperplasia or early oral squamous cell carcinoma.