Potential role of the comprehensive tooth extraction procedure in preventing medication related osteonecrosis of the jaw (MRONJ): a prospective cohort study

作者：Junqing Wang, Yufan Zhang, Dengke Li, Wuyang Zhang, Shuming Wang, Xueni Zheng, Yuan Li, Tiange Deng, Chunlin Zong, Lei Tian, Ping Liu, Yang Xue · 发表于：Orphanet Journal of Rare Diseases · 年份：2025 · DOI：10.1186/s13023-025-04138-9 · 被引用次数：2 · 研究领域：Bone health and treatments、Oral health in cancer treatment、Dental Radiography and Imaging

BACKGROUND: This article aims to elucidate the potential role of a comprehensive tooth extraction procedure in preventing mdication-related osteonecrosis of the jaw (MRONJ) through a prospective cohort study. By systematically assessing clinical outcomes following this procedure, the study seeks to provide evidence regarding its effectiveness in MRONJ prevention, thereby contributing to improved clinical guidelines and patient care related to dental extractions in at-risk populations. METHODS: Patients using anti-resorptive agents (ARAs) who required extraction of at least one tooth were included in the study. Patients' medical history, medication history, and intraoral dental conditions were documented, and CBCT scans were performed. Following a standardized treatment protocol, patients received professional oral cleaning and antibiotics preoperatively. During surgery, minimally invasive extraction and concentrated growth factor (CGF) filling were performed with meticulous suturing whenever possible. Postoperatively, mouthwash was used within one month. Follow-up visits were scheduled at 10, 30, and 90 days to monitor and analyze MRONJ incidence and surgical outcomes. RESULTS: A total of 101 patients were included in the study, with 20 receiving oral ARAs for osteoporosis, 57 receiving intravenous ARAs for osteoporosis, 13 undergoing combination therapy for osteoporosis, and 11 using ARAs for malignancy. Zoledronic acid and denosumab were the most commonly used drugs. Increa...