Atraumatic teeth extraction in bisphosphonate-treated patients.
OBJECTIVE
The purpose of this study was to suggest an alternative technique for atraumatic teeth extraction that would prevent bone exposure and the associated complication of osteonecrosis of the jaws in bisphosphonate (BP)-treated patients, without terminating the treatment.


METHODS
A total of 10 patients treated with BPs for multiple myeloma, metastatic breast cancer, and osteoporosis, requiring dental extractions of nontreatable teeth, were included in this study. The extractions were performed by means of orthodontic elastics placed around the roots, causing slow and gradual exfoliation of the teeth.


RESULTS
The technique was applied to 21 roots of 15 teeth. A total of 19 roots exfoliated spontaneously. Two roots had to be removed with minimal manipulation by forceps. The mean time required for exfoliation was 5.8 weeks. All sockets showed soft tissue secondary healing and there were no signs of inflammation or exposed bone during the 9-month follow-up.


CONCLUSIONS
Atraumatic extraction by use of elastics is a safe technique that may be used in BP-treated patients to prevent osteonecrosis of the jaws.
Regev
Eran
E
Department of Oral and Maxillofacial Surgery, Hadassah-Hebrew University Medical Center and Faculty of Dental Medicine, Jerusalem, Israel. eregev@md.huji.ac.il
Lustmann
Joshua
J
Nashef
Rizan
R
D000328:Adult; D000368:Aged; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D004164:Diphosphonates / Q000627:therapeutic use*; D020724:Elastomers; D006801:Humans; D007571:Jaw Diseases / Q000517:prevention & control; D008875:Middle Aged; D050793:Orthodontic Extrusion / Q000295:instrumentation / Q000379:methods*; D010020:Osteonecrosis / Q000517:prevention & control; D014081:Tooth Extraction / Q000379:methods*
D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D020724:Elastomers