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. 2023 Nov;27(11):6523-6536.
doi: 10.1007/s00784-023-05257-y. Epub 2023 Sep 15.

Oral health conditions in patients under antiresorptive therapy are comparable to unexposed during supportive periodontal care

Antonio Ciardo  1 , Marlinde M Simon  2 , Sinclair Awounvo  3 , Ti-Sun Kim  2
Affiliations

Oral health conditions in patients under antiresorptive therapy are comparable to unexposed during supportive periodontal care

Antonio Ciardo et al. Clin Oral Investig. 2023 Nov.

Abstract

Objectives: To investigate oral health and oral health-related quality of life (OHRQoL) of patients under antiresorptive therapy (ART) during supportive periodontal care (SPC) considering history of medication-related osteonecrosis of the jaw (MRONJ).

Materials and methods: In this cross-sectional study, 100 patients (50 receiving ART (exposed) and 50 without ART (unexposed)) in regular SPC were enrolled for a clinical oral examination and the evaluation of OHRQoL using the OHIP-G14-questionnaire. History of MRONJ was assessed by anamnesis and reviewing patient records.

Results: There were no statistically significant group differences in age (exposed: 70.00 ± 9.07 versus unexposed: 71.02 ± 8.22 years), sex, distribution of systemic diseases and duration of SPC (on average 8.61 ± 5.73 years). Number of teeth (21.02 ± 5.84 versus 21.40 ± 5.42), DMFT (18.38 ± 3.85 versus 17.96 ± 4.08), probing pocket depth (2.31 ± 0.20 versus 2.38 ± 0.26), clinical attachment level (3.25 ± 0.76 versus 3.46 ± 0.58) and bleeding on probing (15.07 ± 11.53 versus 15.77 ± 13.08) were also not significantly different. The OHIP-G14 sum-score was significantly higher in exposed participants (6.10 ± 6.76 versus 3.62 ± 5.22, p = 0.043). History of MRONJ was prevalent in 8% of patients under ART. Periodontal/peri-implant-related MRONJ were reported in three participants with cancer (n = 1 before and n = 2 after active periodontal therapy). History of MRONJ due to endodontic/restorative reasons was reported in one patient with osteoporosis.

Conclusions: Patients under ART in SPC demonstrated similar clinical periodontal and dental status but lower OHRQoL compared to unexposed (not statistically significant). Patient awareness of the MRONJ-risk and appropriate preventive measures should be ensured.

Clinical relevance: SPC in osteoporotic patients under ART appeared safe regarding MRONJ, but further investigations on the MRONJ-risk in patients with different risk-profiles are necessary.

Study registration: clinicaltrials.gov (#NCT04192188).

Keywords: Bisphosphonates; Denosumab; Medication-related osteonecrosis of the jaw; Oral health-related quality of life; Periodontitis; Preventive dentistry.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flow chart study participant selection. Abbreviations: SPC = supportive periodontal care, APT = active periodontal therapy, n = patients, ART = antiresorptive therapy
Fig. 2
Fig. 2
Occurred MRONJ and patients’ characteristics. Abbreviations: MRONJ = medication-related osteonecrosis of the jaw, n = patients, APT = active periodontal therapy, SPC = supportive periodontal care, ART = antiresorptive therapy
See this image and copyright information in PMC

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