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01-11-2021 | Tooth Extraction | Original Article

Denosumab-related osteonecrosis of the jaw after tooth extraction and the effects of a short drug holiday in cancer patients: a multicenter retrospective study

Authors: T. Hasegawa, N. Ueda, SI. Yamada, S. Kato, E. Iwata, S. Hayashida, Y. Kojima, M. Shinohara, I. Tojo, H. Nakahara, T. Yamaguchi, T. Kirita, H. Kurita, Y. Shibuya, S. Soutome, M. Akashi, Japanese Study Group of Co-operative Dentistry with Medicine (JCDM)

Published in: Osteoporosis International | Issue 11/2021

Abstract

Summary

Pre-existing inflammation, corticosteroid therapy, periapical periodontitis, longer duration of denosumab therapy, and female sex were significantly associated with an increased risk of denosumab-related osteonecrosis of the jaw after tooth extraction in patients with cancer on oncologic doses of denosumab. A short drug holiday did not protect against this complication.

Introduction

This study retrospectively investigated the relationship between various risk factors, including brief discontinuation of denosumab, and development of denosumab-related osteonecrosis of the jaw (DRONJ) after tooth extraction in patients with cancer who were receiving oncologic doses of this agent.

Methods

Data were collected on demographic characteristics, duration of denosumab therapy, whether or not denosumab was discontinued before tooth extraction (drug holiday), duration of discontinuation, presence of pre-existing inflammation, and whether or not additional surgical procedures were performed. Risk factors for DRONJ after tooth extraction were evaluated by univariate and multivariate analyses.

Results

A total of 136 dental extractions were performed in 72 patients (31 men, 41 women) with cancer who were receiving oncologic doses of denosumab. Post-extraction DRONJ was diagnosed in 39 teeth (28.7%) in 25 patients. Tooth extraction was significantly associated with development of DRONJ only in patients with pre-existing inflammation (odds ratio [OR] 243.77), those on corticosteroid therapy (OR 73.50), those with periapical periodontitis (OR 14.13), those who had been taking oncologic doses of denosumab for a longer period (OR 4.69), and in women (OR 1.04). There was no significant difference in the occurrence of DRONJ between patients who had a drug holiday before tooth extraction and those who did not.

Conclusions

These findings suggest that inflamed teeth should be extracted immediately in patients with cancer who are receiving oncologic doses of denosumab. Drug holidays have no significant impact on the risk of DRONJ.

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Title: Denosumab-related osteonecrosis of the jaw after tooth extraction and the effects of a short drug holiday in cancer patients: a multicenter retrospective study
Authors: T. Hasegawa
N. Ueda
SI. Yamada
S. Kato
E. Iwata
S. Hayashida
Y. Kojima
M. Shinohara
I. Tojo
H. Nakahara
T. Yamaguchi
T. Kirita
H. Kurita
Y. Shibuya
S. Soutome
M. Akashi
Japanese Study Group of Co-operative Dentistry with Medicine (JCDM)
Publication date: 01-11-2021
Publisher: Springer London
Keywords: Tooth Extraction
Bisphosphonate
Osteonecrosis
Tooth Extraction
Denosumab
Denosumab
Published in: Osteoporosis International / Issue 11/2021
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI: https://doi.org/10.1007/s00198-021-05995-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Denosumab-related osteonecrosis of the jaw after tooth extraction and the effects of a short drug holiday in cancer patients: a multicenter retrospective study

Abstract

Summary

Introduction

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Summary

Introduction

Methods

Results

Conclusions

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