Journal of Periodontal and Implant Science

Korean Academy of Periodontology (대한치주과학회)
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Pulp and periapical disease as a risk factor for osteonecrosis of the jaw: a national cohort-based study in Korea

  • Hyeong-Jin Baek (Department of Periodontology, Section of Dentistry, Seoul National University Bundang Hospital) ;
  • Hyejin Lee (Department of Family Medicine, Seoul National University Bundang Hospital) ;
  • Jae-Ryun Lee (Department of Family Medicine, Seoul National University Bundang Hospital) ;
  • Jung-Hyun Park (Department of Oral and Maxillofacial Surgery, Research Institute for Intractable Osteonecrosis of the Jaw, College of Medicine, Ewha Womans University) ;
  • Keun-Suh Kim (Department of Periodontology, Section of Dentistry, Seoul National University Bundang Hospital) ;
  • Min-Jeong Kwoen (Department of Periodontology, Section of Dentistry, Seoul National University Bundang Hospital) ;
  • Tae-Yeon Lee (Department of Conservative Dentistry, Yeouido ST. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Jin-Woo Kim (Department of Oral and Maxillofacial Surgery, Research Institute for Intractable Osteonecrosis of the Jaw, College of Medicine, Ewha Womans University) ;
  • Hyo-Jung Lee (Department of Periodontology, Section of Dentistry, Seoul National University Bundang Hospital)
  • Received : 2022.06.17
  • Accepted : 2023.04.03
  • Published : 2024.04.30
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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.

Keywords

Acknowledgement

This work was supported by Seoul National University Bundang Hospital (grant numbers 02-2018-042 and 06-2020-020) and the National Research Foundation of Korea (NRF) grant funded by the Korean government (MSIT) (grant number 2020R1A2C4001842).

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