Pulp and periapical disease as a risk factor for osteonecrosis of the jaw: a national cohort-based study in Korea

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

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: This longitudinal cohort study aimed to evaluate the relationship between osteonecrosis of the jaw and pulp and periapical disease in patients who were administered bisphosphonates. Methods: Using data from a nationwide cohort, we examined the association among dental caries, pulp and periapical disease, and osteonecrosis of the jaw in women aged?>50 years who received bisphosphonates for more than 1 year between 2002 and 2015. Because of ambiguities in the diagnosis of osteonecrosis of the jaw in population-based data, we operationally defined and categorized the condition into established and potential osteonecrosis of the jaw. Results: Pulp and periapical disease significantly increased the development of both established and potential osteonecrosis of the jaw (hazard ratio, 2.21; 95% confidence interval, 1.40–3.48; and hazard ratio, 2.22; 95% confidence interval, 1.65–2.98, respectively). Root canal treatment did not have any influence on the development of osteonecrosis of the jaw. Conclusions: Pulp and periapical disease may be a major risk factor for osteonecrosis of the jaw. The study findings suggest that patients should undergo regular dental examinations to detect pulp and periapical disease before or during the administration of bisphosphonates and that root canal treatment should be considered to decrease the risk of osteonecrosis of the jaw.

Original languageEnglish
Pages (from-to)65-74
Number of pages10
JournalJournal of Periodontal and Implant Science
Volume54
Issue number2
DOIs
StatePublished - 2024

Bibliographical note

Publisher Copyright:
© (2024), Korean Academy of Periodontology This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/).

Keywords

  • Bisphosphonate-associated osteonecrosis of the jaw
  • Bisphosphonates
  • Inflammation
  • Periapical disease
  • Pulpitis
  • Root canal therapy

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