title: Prevention of medication-related osteonecrosis of the jaws secondary to tooth extractions. A systematic review.
abstract: BACKGROUND
  A study was made to identify the most effective protocol for reducing the risk of osteonecrosis of the jaws (ONJ) following tooth extraction in patients subjected to treatment with antiresorptive or antiangiogenic drugs.
  
  
  METHODS
  A MEDLINE and SCOPUS search (January 2003 - March 2015) was made with the purpose of conducting a systematic literature review based on the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. All articles contributing information on tooth extractions in patients treated with oral or intravenous antiresorptive or antiangiogenic drugs were included.
  
  
  RESULTS
  Only 13 of the 380 selected articles were finally included in the review: 11 and 5 of them offered data on patients treated with intravenous and oral bisphosphonates, respectively. No randomized controlled trials were found - all publications corresponding to case series or cohort studies. The prevalence of ONJ in the patients treated with intravenous and oral bisphosphonates was 6,9% (range 0-34.7%) and 0.47% (range 0-2.5%), respectively. The main preventive measures comprised local and systemic infection control.
  
  
  CONCLUSIONS
  No conclusive scientific evidence is available to date on the efficacy of ONJ prevention protocols in patients treated with antiresorptive or antiangiogenic drugs subjected to tooth extraction.
authors.affiliation: Facultad de Odontología, Calle Entrerríos s/n, 15782 - Santiago de Compostela (Spain), marcio.diniz@usc.es.
authors.forename: Márcio
authors.initials: M
authors.lastname: Diniz-Freitas
authors.forename: Jacobo
authors.initials: J
authors.lastname: Limeres
mesh_terms: D020533:Angiogenesis Inhibitors / Q000009:adverse effects*; D050071:Bone Density Conservation Agents / Q000009:adverse effects*; D006801:Humans; D007571:Jaw Diseases / Q000139:chemically induced* / Q000517:prevention & control*; D010020:Osteonecrosis / Q000139:chemically induced* / Q000517:prevention & control*; D011183:Postoperative Complications / Q000139:chemically induced* / Q000517:prevention & control*; D014081:Tooth Extraction
chemical_list: D020533:Angiogenesis Inhibitors; D050071:Bone Density Conservation Agents
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