Periodontal Disease as a Risk Factor for Bisphosphonate-Related Osteonecrosis of the Jaw
Identifieur interne : 001019 ( Main/Merge ); précédent : 001018; suivant : 001020Periodontal Disease as a Risk Factor for Bisphosphonate-Related Osteonecrosis of the Jaw
Auteurs : Vivek Thumbigere-Math [États-Unis] ; Bryan S. Michalowicz [États-Unis] ; James S. Hodges [États-Unis] ; Michaela L. Tsai [États-Unis] ; Karen K. Swenson [États-Unis] ; Laura Rockwell [États-Unis] ; Rajaram Gopalakrishnan [États-Unis]Source :
- Journal of periodontology [ 0022-3492 ] ; 2013.
Abstract
Previous case reports and animal studies suggest periodontitis is associated with bisphosphonate-related osteonecrosis of the jaw (BRONJ). We conducted a case-control study to evaluate the association between clinical and radiographic measures of periodontal disease and BRONJ.
25 BRONJ patients were matched with 48 controls. Trained examiners measured probing depth (PD), clinical attachment level (CAL), and bleeding on probing (BOP) on all teeth except third molars, and gingival and plaque indices on six index teeth. Alveolar bone height was measured from orthopantomograms. Most BRONJ cases were using antibiotics (48%) or a chlorhexidine mouthrinse (84%) at enrollment. Adjusted comparisons of cases vs. controls used multiple linear regression.
The average number of BP infusions was significantly higher in BRONJ cases compared to controls (38.4 vs 18.8, p=0.0001). In unadjusted analyses, BRONJ cases had more missing teeth (7.8 vs 3.1, p=0.002) and high average CAL (2.18 vs 1.56 mm, p=0.047) and percent of sites with CAL ≥3 mm (39.0 vs 23.3, p=0.039) than controls. Also, BRONJ cases had lower average bone height (as a fraction of tooth length, 0.59 vs 0.62, p=0.004) and more teeth with bone height under half of tooth length (20% vs 6%, p=0.001). These differences remained significant after adjusting for age, sex, smoking, and number of bisphosphonate infusions.
BRONJ patients have fewer teeth, greater CAL, and less alveolar bone support compared to controls after adjusting for number of bisphosphonate infusions. Group differences in antibiotics and chlorhexidine rinse usage may have masked differences in the other clinical measures.
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DOI: 10.1902/jop.2013.130017
PubMed: 23786404
PubMed Central: 3972496
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Michalowicz</name><affiliation wicri:level="2"><nlm:aff id="A1">Division of Periodontology, University of Minnesota School of Dentistry, Minneapolis, MN</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Minnesota</region></placeName><wicri:cityArea>Division of Periodontology, University of Minnesota School of Dentistry, Minneapolis</wicri:cityArea></affiliation></author><author><name sortKey="Hodges, James S" sort="Hodges, James S" uniqKey="Hodges J" first="James S." last="Hodges">James S. Hodges</name><affiliation wicri:level="2"><nlm:aff id="A2">Division of Biostatistics, University of Minnesota School of Public Health, Minneapolis, MN</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Minnesota</region></placeName><wicri:cityArea>Division of Biostatistics, University of Minnesota School of Public Health, Minneapolis</wicri:cityArea></affiliation></author><author><name sortKey="Tsai, Michaela L" sort="Tsai, Michaela L" uniqKey="Tsai M" first="Michaela L." last="Tsai">Michaela L. Tsai</name><affiliation wicri:level="2"><nlm:aff id="A3">Oncology Research Department, Park Nicollet Institute, Minneapolis, MN</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Minnesota</region></placeName><wicri:cityArea>Oncology Research Department, Park Nicollet Institute, Minneapolis</wicri:cityArea></affiliation></author><author><name sortKey="Swenson, Karen K" sort="Swenson, Karen K" uniqKey="Swenson K" first="Karen K." last="Swenson">Karen K. 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We conducted a case-control study to evaluate the association between clinical and radiographic measures of periodontal disease and BRONJ.</p></sec><sec id="S2"><title>Methods</title><p id="P2">25 BRONJ patients were matched with 48 controls. Trained examiners measured probing depth (PD), clinical attachment level (CAL), and bleeding on probing (BOP) on all teeth except third molars, and gingival and plaque indices on six index teeth. Alveolar bone height was measured from orthopantomograms. Most BRONJ cases were using antibiotics (48%) or a chlorhexidine mouthrinse (84%) at enrollment. Adjusted comparisons of cases vs. controls used multiple linear regression.</p></sec><sec id="S3"><title>Results</title><p id="P3">The average number of BP infusions was significantly higher in BRONJ cases compared to controls (38.4 vs 18.8, p=0.0001). In unadjusted analyses, BRONJ cases had more missing teeth (7.8 vs 3.1, p=0.002) and high average CAL (2.18 vs 1.56 mm, p=0.047) and percent of sites with CAL ≥3 mm (39.0 vs 23.3, p=0.039) than controls. Also, BRONJ cases had lower average bone height (as a fraction of tooth length, 0.59 vs 0.62, p=0.004) and more teeth with bone height under half of tooth length (20% vs 6%, p=0.001). These differences remained significant after adjusting for age, sex, smoking, and number of bisphosphonate infusions.</p></sec><sec id="S4"><title>Conclusions</title><p id="P4">BRONJ patients have fewer teeth, greater CAL, and less alveolar bone support compared to controls after adjusting for number of bisphosphonate infusions. Group differences in antibiotics and chlorhexidine rinse usage may have masked differences in the other clinical measures.</p></sec></div></front></TEI></record>Pour manipuler ce document sous Unix (Dilib)
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