A systematic review assessing occurrence of medication-related osteonecrosis of the jaw following dental procedures

• Autor(a) principal: Lara, Shimelly Monteiro de Castro
• Data de Publicação: 2022
• Outros Autores: Muniz, Francisco Wilker Mustafa Gomes, Gerônimo, Ana Beatriz Caetano, Santos, Cinthia Studzinski dos, Barbosa Calcia, Thayanne Brasil
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Brazilian journal of oral sciences (Online)
• DOI: 10.20396/bjos.v21i00.8666585
• Texto Completo: https://periodicos.sbu.unicamp.br/ojs/index.php/bjos/article/view/8666585
• topic: Bisphosphonate-associated osteonecrosis of the jaw; Bone density conservation agents; Diphosphonates; Osteonecrosis; Surgery, oral

Aim: This study aimed to systematically review existing literature regarding the association between dental procedures—such as tooth extractions and periodontal therapy—and occurrence of medication-related osteonecrosis of the jaw (MRONJ) in individuals using bone-modifying drugs. Methods: Search strategies were performed in PubMed, Scopus, Web of Science and Cochrane Library for a timeframe ending in December 2021. Study selection, data extraction and risk of bias were analyzed independently by two researchers. Three meta-analyses were performed, estimating the crude risk ratio (RR), the adjusted odds ratio (OR) and the adjusted hazard ratio (HR) for the association between tooth extraction and MRONJ. Results: Of the 1,654 studies initially retrieved, 17 were ultimately included. The majority of patients with MRONJ in these studies were female, with a mean age of 64 years. Zoledronic acid was the most commonly used drug among patients with MRONJ, and cancer was the most frequent underlying health condition. Regarding the performed meta-analyses, crude and adjusted analyses demonstrated that tooth extraction increased the risk for MRONJ by 4.28 (95% confidence interval [95%CI]: 1.73–10.58), the OR for MRONJ by 26.94 (95%CI: 4.17–174.17), and the HR for MRONJ by 9.96 (95%CI: 4.04–24.55). Conclusion: It was concluded that performing dental procedures, especially tooth extraction, in patients using bone-modifying drugs increased the risk of MRONJ occurrence and, therefore, should be avoided. Further studies, using adjusted data, are warranted.