title: Tooth extraction in patients on zoledronic acid therapy.
abstract: OBJECTIVE
  Surgical management of patients following zoledronic acid therapy is particularly difficult, since the dental extraction is the main cause of BRONJ.
  
  
  METHODS
  A case-control study was conducted on 176 patients treated with intravenous (IV) bisphosphonates for oncologic pathologies who also underwent dental extractions. The study was divided randomly into two groups: 91 were treated with Plasma Rich in Growth Factor Plasma (PRGF) (study group) and the other 85 were not treated with the growth factor preparation (control group).
  
  
  RESULTS
  Panoramic X-ray and computed tomography were performed both before and 60 months after surgery. By clinical and radiological diagnosis, BRONJ was diagnosed in only 5 patients in the control group at an average of 91, 6 days after tooth extraction.
  
  
  CONCLUSIONS
  We hypothesize that Plasma Rich in Growth Factor (PRGF) is important for the successful treatment of patients on bisphosphonates to restore the osteoblast/osteoclast homeostatic cycles via autologous cytokines. Moreover, this protocol reduces the risk of BRONJ when it is necessary to perform dental extractions in patients undergoing IV bisphosphonate treatment.
authors.affiliation: Department of Clinical Physiopathology, Oral Surgery Unit, Dentistry Section, University of Turin, Turin 10126, Italy. marco.mozzati@libero.it
authors.forename: Marco
authors.initials: M
authors.lastname: Mozzati
authors.forename: Valentina
authors.initials: V
authors.lastname: Arata
authors.forename: Giorgia
authors.initials: G
authors.lastname: Gallesio
mesh_terms: D016022:Case-Control Studies; D004164:Diphosphonates / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D007093:Imidazoles / Q000009:adverse effects* / Q000627:therapeutic use; D007571:Jaw Diseases / Q000139:chemically induced* / Q000150:complications / Q000000981:diagnostic imaging; D010020:Osteonecrosis / Q000139:chemically induced* / Q000150:complications / Q000000981:diagnostic imaging; D011862:Radiography, Panoramic; D014057:Tomography, X-Ray Computed; D014081:Tooth Extraction; D000077211:Zoledronic Acid
chemical_list: D004164:Diphosphonates; D007093:Imidazoles; D000077211:Zoledronic Acid