Abstract
An increasing number of patients with medication-related osteonecrosis of the jaws
(MRONJ) has recently been reported. It is still being debated whether the presence
or placement of dental implants can lead to MRONJ, so the aim of this study was to
find out whether dental implants are a risk factor for MRONJ. From January 2003-January
2019 180 patients with MRONJ were seen at the Leiden University Medical Center. Luxating
moments for the onset of MRONJ were calculated retrospectively. We collected clinical
data and details of antiresorptive medication and found 22 patients with both dental
implants and MRONJ. In 18 patients the implants were in the region of the MRONJ and
they were included in this study, 14 who had had implants before using antiresorptive
drugs and four who had had antiresorptive drugs before or at the time that the implants
were placed. The median times between the placement of implants and the diagnosis
of MRONJ in these two groups were 24 months and 6 months, respectively. Among the
47 implants, 30 were located in the necrotic region, and all 30 were either lost spontaneously
or had to be removed during treatment of MRONJ. Our results show an increased risk
for developing MRONJ in patients with dental implants. Both peri-implantitis around
previously placed implants, and insertion of dental implants, are risk factors. Prevention
of peri-implantitis and caution when inserting dental implants in patients who take
antiresorptive medication are therefore important.
Keywords
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Article info
Publication history
Published online: July 03, 2020
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© 2020 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
