Association between periodontal disease, tooth extraction, and medication-related osteonecrosis of the jaw in women receiving bisphosphonates: A national cohort-based study

Min Jeong Kwoen, Jung Hyun Park, Keun Suh Kim, Jae Ryun Lee, Jin Woo Kim, Hyejin Lee, Hyo Jung Lee

Research output: Contribution to journalArticlepeer-review

6 Scopus citations

Abstract

Background: We investigated whether periodontal diseases contribute to the development of medication-related osteonecrosis of the jaw (MRONJ) in addition to tooth extraction, which is a major risk factor for MRONJ occurrence. Methods: This retrospective, nationwide cohort study was performed using South Korea's National Health Insurance Service database on women aged > 50 years who took bisphosphonates for at least 1 year between 2010 and 2015. MRONJ, periodontal disease, and tooth extraction were defined using the claims data. Results: Among the 27,168 patients analyzed, the incidence of confirmed MRONJ was significantly higher in the periodontal disease group (0.58%) than in the nonperiodontal disease group (0.31%). While extraction alone showed an increased risk of MRONJ development (hazard ratio [HR] = 1.61, 95% confidence interval [CI]: 0.74–3.52), periodontal disease without tooth extraction also indicated a similar risk (HR = 1.68, 95% CI: 0.86–3.28); when a history of both periodontal disease and tooth extraction was present, the HR significantly increased to 2.55 (95% CI: 1.41–4.64). Conclusions: The risk of MRONJ increased significantly when tooth extraction was performed in patients diagnosed with periodontal disease; therefore, periodontal diseases should be proactively managed in patients taking bisphosphonates.

Original languageEnglish
Pages (from-to)98-107
Number of pages10
JournalJournal of Periodontology
Volume94
Issue number1
DOIs
StatePublished - Jan 2023

Bibliographical note

Funding Information:
This study was analyzed using the National Health Information Database (NHIS‐2020–2‐154) created by the National Health Insurance Service (NHIS). The National Health Information Database was provided by the NHIS of South Korea. The results were not influenced by the NHIS. The authors express our gratitude for the cooperation of NHIS. This work was supported by the Seoul National University Bundang Hospital (Nos. 02‐2018‐042 and 06‐2020‐020) and National Research Foundation of Korea (NRF) grant funded by the Korean government (MSIT) (Nos. 2020R1A2C4001842 and 2021R1A2C100646611).

Funding Information:
This study was analyzed using the National Health Information Database (NHIS-2020–2-154) created by the National Health Insurance Service (NHIS). The National Health Information Database was provided by the NHIS of South Korea. The results were not influenced by the NHIS. The authors express our gratitude for the cooperation of NHIS. This work was supported by the Seoul National University Bundang Hospital (Nos. 02-2018-042 and 06-2020-020) and National Research Foundation of Korea (NRF) grant funded by the Korean government (MSIT) (Nos. 2020R1A2C4001842 and 2021R1A2C100646611).

Publisher Copyright:
© 2022 The Authors. Journal of Periodontology published by Wiley Periodicals LLC on behalf of American Academy of Periodontology.

Keywords

  • bisphosphonate-related osteonecrosis of the jaw
  • osteonecrosis
  • periodontal diseases
  • tooth extraction

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