Objective
The aim of this study was to investigate the frequency of osteoradionecrosis/medication-related
osteonecrosis of the jaw (ORN/MRONJ) after dental extraction with use of postextraction
antibiotic coverage without prophylactic hyperbaric oxygen (HBO) in patients who received
radiotherapy to head and neck (RT-HN) or antiresorptive medications and to determine
possible associated factors.
Study Design
A retrospective study was conducted in patients who had a history of RT-HN or exposure
to antiresorptives and who underwent dental extractions from 2003 to 2019. According
to the clinical protocol, patients received amoxicillin 500 mg, 3 times daily (TID)
for at least 14 days, and chlorhexidine 0.12% rinses, 2 times daily (BID), after extraction
(or an alternative antibiotic if allergic to amoxicillin). HBO was not used for patients
with RT-HN.
Results
Ninety patients underwent a total of 243 extractions. Fifty patients (55.5%) received
a median of 54.1 Gray to the extraction site and 40 (44.4%) were on antiresorptives.
None of the patients received both RT and antiresorptives. Of 40 patients, 3 (7.5%)
developed MRONJ, and of 50 patients, 1 (2%) developed ORN. Among those at risk for
MRONJ, male gender and concomitant immunosuppressant medications were associated with
MRONJ development (P < .05).
Conclusions
In our patient cohort, the rate of postextraction ORN/MRONJ was lower and comparable
with the rates reported in the literature. Larger prospective studies are required
to validate the efficacy of postextraction antibiotics in reducing ONJ.
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Article info
Publication history
Published online: July 25, 2020
Accepted:
July 5,
2020
Received in revised form:
June 30,
2020
Received:
April 15,
2020
Identification
Copyright
Published by Elsevier Inc.
