Mronj incidence after multiple teeth extractions in patients taking oral bisphosphonates without “drug holiday”: A retrospective chart review

Introduction. The present retrospective chart review registered Medication-Related Osteonecrosis of the Jaw (MRONJ) occurrence after multiple adjacent teeth extractions in patients taking oral bisphosphonates (BPs) for osteoporosis for at least 3 years without “drug holiday”. Methods. Data from subjects ≥ 50 years old, requiring ≥ 2 tooth extractions of adjacent teeth, treated with oral BPs for osteoporosis for at least 3 years, who underwent multiple adjacent teeth extractions with a 12 months follow-up, at the Complex Operating Unit of Odontostomatology, Azienda Ospedaliero-Universitaria San Giovanni di Dio e Ruggi d’Aragona, Salerno, Italy, were included in the study. Tooth extractions were planned in case of residual roots, destroying tooth decays, dental fractures and severe endodontic and periodontal infections. No oral BPs suspension was considered. Surgeries were performed by a single expert operator as a part of the standard clinical procedure. Follow-up consisted of weekly controls for the first month after extractions and monthly recalls for the next 11 months. Results. Data from 58 patients charts accounting for 123 teeth extractions were included in the survey. No MRONJ development was registered. Discussion and conclusions. Besides the positive observation, higher evidence level studies should be conducted on wider samples to better estimate MRONJ risk in osteoporotic patients assuming oral BPs without drug holiday and undergoing teeth extractions