Periodontal Disease as a Risk Factor for Bisphosphonate-Related Osteonecrosis of the Jaw
Identifieur interne : 002700 ( Pmc/Curation ); précédent : 002699; suivant : 002701Periodontal 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. Swenson</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="Rockwell, Laura" sort="Rockwell, Laura" uniqKey="Rockwell L" first="Laura" last="Rockwell">Laura Rockwell</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="Gopalakrishnan, Rajaram" sort="Gopalakrishnan, Rajaram" uniqKey="Gopalakrishnan R" first="Rajaram" last="Gopalakrishnan">Rajaram Gopalakrishnan</name><affiliation wicri:level="2"><nlm:aff id="A4">Division of Oral and Maxillofacial Pathology, 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 Oral and Maxillofacial Pathology, University of Minnesota School of Dentistry, Minneapolis</wicri:cityArea></affiliation></author></analytic><series><title level="j">Journal of periodontology</title><idno type="ISSN">0022-3492</idno><idno type="eISSN">1943-3670</idno><imprint><date when="2013">2013</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="S1"><title>Background</title><p id="P1">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.</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><pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<pmc-dir>properties manuscript</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-journal-id">8000345</journal-id><journal-id journal-id-type="pubmed-jr-id">5144</journal-id><journal-id journal-id-type="nlm-ta">J Periodontol</journal-id><journal-id journal-id-type="iso-abbrev">J. Periodontol.</journal-id><journal-title-group><journal-title>Journal of periodontology</journal-title></journal-title-group><issn pub-type="ppub">0022-3492</issn><issn pub-type="epub">1943-3670</issn></journal-meta><article-meta><article-id pub-id-type="pmid">23786404</article-id><article-id pub-id-type="pmc">3972496</article-id><article-id pub-id-type="doi">10.1902/jop.2013.130017</article-id><article-id pub-id-type="manuscript">NIHMS533526</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>Periodontal Disease as a Risk Factor for Bisphosphonate-Related Osteonecrosis of the Jaw</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Thumbigere-Math</surname><given-names>Vivek</given-names></name><degrees>BDS, PhD</degrees><xref ref-type="aff" rid="A1">*</xref></contrib><contrib contrib-type="author"><name><surname>Michalowicz</surname><given-names>Bryan S.</given-names></name><degrees>DDS, MS</degrees><xref ref-type="aff" rid="A1">*</xref></contrib><contrib contrib-type="author"><name><surname>Hodges</surname><given-names>James S.</given-names></name><degrees>PhD</degrees><xref ref-type="aff" rid="A2">†</xref></contrib><contrib contrib-type="author"><name><surname>Tsai</surname><given-names>Michaela L.</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A3">‡</xref></contrib><contrib contrib-type="author"><name><surname>Swenson</surname><given-names>Karen K.</given-names></name><degrees>RN, PhD</degrees><xref ref-type="aff" rid="A3">‡</xref></contrib><contrib contrib-type="author"><name><surname>Rockwell</surname><given-names>Laura</given-names></name><degrees>RN</degrees><xref ref-type="aff" rid="A3">‡</xref></contrib><contrib contrib-type="author"><name><surname>Gopalakrishnan</surname><given-names>Rajaram</given-names></name><degrees>BDS, PhD</degrees><xref ref-type="aff" rid="A4">¶</xref></contrib></contrib-group><aff id="A1"><label>*</label>Division of Periodontology, University of Minnesota School of Dentistry, Minneapolis, MN</aff><aff id="A2"><label>†</label>Division of Biostatistics, University of Minnesota School of Public Health, Minneapolis, MN</aff><aff id="A3"><label>‡</label>Oncology Research Department, Park Nicollet Institute, Minneapolis, MN</aff><aff id="A4"><label>¶</label>Division of Oral and Maxillofacial Pathology, University of Minnesota School of Dentistry, Minneapolis, MN</aff><author-notes><corresp id="FN1">Corresponding Author: Rajaram Gopalakrishnan BDS, PhD, Associate Professor, Division of Oral and Maxillofacial Pathology, Department of Diagnostic and Biological Sciences, University of Minnesota School of Dentistry, 515 Delaware Street SE, Minneapolis, MN 55455. Tel: 612-624-0918/Fax: 612-626-3076, <email>gopal007@umn.edu</email></corresp></author-notes><pub-date pub-type="nihms-submitted"><day>27</day><month>3</month><year>2014</year></pub-date><pub-date pub-type="epub"><day>20</day><month>6</month><year>2013</year></pub-date><pub-date pub-type="ppub"><month>2</month><year>2014</year></pub-date><pub-date pub-type="pmc-release"><day>02</day><month>4</month><year>2014</year></pub-date><volume>85</volume><issue>2</issue><fpage>226</fpage><lpage>233</lpage><pmc-comment>elocation-id from pubmed: 10.1902/jop.2013.130017</pmc-comment>
<abstract><sec id="S1"><title>Background</title><p id="P1">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.</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></abstract><kwd-group><kwd>Bisphosphonates</kwd><kwd>Periodontitis</kwd><kwd>Periodontal Disease</kwd><kwd>Alveolar Bone Loss</kwd><kwd>Osteonecrosis</kwd><kwd>Bisphosphonate-related osteonecrosis of the jaw</kwd></kwd-group></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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