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Arch Med Sci. 2014 Feb 24;10(1):117-23. doi: 10.5114/aoms.2014.40738. Epub 2014 Feb 23.

Association of dental and periodontal status with bisphosphonate-related osteonecrosis of the jaws. A retrospective case controlled study.

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  • 1Department of Maxillofacial Surgery, Klinikum Minden, Germany.

Abstract

INTRODUCTION:

To assess the association of oral hygiene, dental caries, and periodontal status with bisphosphonate-related osteonecrosis of the jaws.

MATERIAL AND METHODS:

A retrospective case-control study on 81 patients treated for neoplasms with bone metastases. Twenty-nine patients with bone necrosis and 52 controls treated with bisphosphonates were compared using the Oral Hygiene Index, Decay, Missing, Filled Teeth, Community Periodontal Index of Treatment Needs, and Residual Periodontal Bone. The null hypothesis stated that there was no difference in parameters of oral health between patients with and without bone necrosis. Differences of means of above-mentioned variables were compared between the groups with Student's t-test or Mann-Whitney rank sum test and χ(2) test. Value of p ≤ 0.05 was considered significant.

RESULTS:

Poorer oral hygiene (OHIs 1.94 vs. 1.32; p = 0.065), more advanced dental caries (DMFT 26.85 vs. 22.87; p = 0.05), and more advanced periodontal disease (CPITN: = 0: 21.05% vs. 42.51%; = 1 13.16% vs. 7.29%; = 2: 0% vs. 15.38%; = 3: 65.79% vs. 28.34%; = 4: 0% vs. 6.48%, Residual periodontal bone 73.1% vs. 80.51%; p = 0,001) were characteristic of patients with bisphosphonate related jaw necrosis when compared with control group. An advanced dental caries or periodontal disease required surgical intervention which directly contributed to the development of the bone necrosis.

CONCLUSIONS:

Dental and periodontal disease can lead to bisphosphonate-related osteonecrosis of the jaw. Oncologic patients treated with bisphosphonates should be offered preventive care to reduce dental plaque, calculus, dental caries, and periodontal disease.

KEYWORDS:

dental status; jaw; necrosis; oral health; periodontal status

PMID:
24701224
[PubMed]
PMCID:
PMC3953981
Free PMC Article
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