A retrospective clinical and radiographic study on healing of periradicular lesions in patients taking oral bisphosphonates.
BACKGROUND
Bisphosphonates have been related to impaired bone remodeling. The impact of oral bisphosphonates on periradicular healing has not been studied. The purpose of this study was to evaluate the healing of periradicular lesions in patients taking oral bisphosphonates after root canal therapy.


METHODS
Thirty-four teeth with preoperative periradicular radiolucencies were identified in patients undergoing oral bisphosphonate therapy. These cases were examined clinically and radiographically to determine treatment outcome. Thirty-eight control teeth were selected from a pool of patients not taking bisphosphonates. Nonsurgical root canal treatment and retreatment was performed by endodontic residents and undergraduate dental students at Baylor College of Dentistry using nonstandardized protocols.


RESULTS
In the bisphosphonate group, 73.5% of the lesions healed, whereas the control cases had a healing rate of 81.6%. There was no statistically significant difference between the groups (p > 0.05).


CONCLUSIONS
The results of this preliminary short-term study suggest that patients taking long-term oral bisphosphonates can expect a satisfactory outcome with evidence of periradicular healing after conventional root canal treatment. Thus, root canal treatment may be considered a safe and realistic alternative to extraction in patients on bisphosphonate therapy.
Hsiao
Angela
A
Department of Endodontics, Baylor College of Dentistry, The Texas A&M University System Health Science Center, Dallas, TX, USA.
Glickman
Gerald
G
He
Jianing
J
D000284:Administration, Oral; D000368:Aged; D000369:Aged, 80 and over; D019386:Alendronate / Q000008:administration & dosage; D050071:Bone Density Conservation Agents / Q000008:administration & dosage*; D016022:Case-Control Studies; D003188:Composite Resins / Q000627:therapeutic use; D004164:Diphosphonates / Q000008:administration & dosage*; D012968:Etidronic Acid / Q000008:administration & dosage / Q000031:analogs & derivatives; D005500:Follow-Up Studies; D006171:Gutta-Percha / Q000627:therapeutic use; D006801:Humans; D000077557:Ibandronic Acid; D008875:Middle Aged; D010483:Periapical Diseases / Q000000981:diagnostic imaging / Q000628:therapy*; D011859:Radiography; D012189:Retrospective Studies; D000068296:Risedronic Acid; D012387:Root Canal Filling Materials / Q000627:therapeutic use; D018915:Root Canal Preparation / Q000379:methods; D016037:Single-Blind Method; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology
D050071:Bone Density Conservation Agents; D003188:Composite Resins; D004164:Diphosphonates; C511498:Real Seal composite resin; D012387:Root Canal Filling Materials; D006171:Gutta-Percha; D000068296:Risedronic Acid; D012968:Etidronic Acid; D000077557:Ibandronic Acid; D019386:Alendronate