title: Risk factors of osteonecrosis of the jaw after tooth extraction in osteoporotic patients on oral bisphosphonates.
abstract: OBJECTIVE
  The aim of this study was to investigate the incidence of bisphosphonate-related osteonecrosis of the jaw (BRONJ) after tooth extraction in patients with osteoporosis on oral bisphosphonates in Korea and to evaluate local factors affecting the development of BRONJ.
  
  
  METHODS
  The clinical records of 320 patients who underwent dental extraction while receiving oral bisphosphonates were reviewed. All patients had a healing period of more than 6 months following the extractions. Each patient's clinical record was used to assess the incidence of BRONJ; if BRONJ occurred, a further radiographic investigation was carried out to obtain a more definitive diagnosis. Various local factors including age, gender, extraction site, drug type, duration of administration, and C-terminal telopeptide (CTx) level were retrieved from the patients' clinical records for evaluating their effect on the incidence of BRONJ.
  
  
  RESULTS
  Among the 320 osteoporotic patients who underwent tooth extraction, 11 developed BRONJ, reflecting an incidence rate of 3.44%. Out of the local factors that may affect the incidence of BRONJ, gender, drug type, and CTx level showed no statistically significant effects, while statistically significant associations were found for age, extraction site, and duration of administration. The incidence of BRONJ increased with age, was greater in the mandible than the maxilla, and was associated with a duration of administration of more than 3 years.
  
  
  CONCLUSIONS
  Tooth extraction in patients on oral bisphosphonates requires careful consideration of their age, the extraction site, and the duration of administration, and close postoperative follow-up should be carried out to facilitate effective early management.
authors.affiliation: Department of Oral and Maxillofacial Radiology, Yonsei University, College of Dentistry, Seoul, Korea.
authors.forename: Ho-Gul
authors.initials: HG
authors.lastname: Jeong
authors.affiliation: Department of Oral and Maxillofacial Radiology, Yonsei University, College of Dentistry, Seoul, Korea.
authors.forename: Jae Joon
authors.initials: JJ
authors.lastname: Hwang
authors.affiliation: Department of Oral and Maxillofacial Radiology, Yonsei University, College of Dentistry, Seoul, Korea.
authors.forename: Jeong-Hee
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Department of Oral and Maxillofacial Radiology, Yonsei University, College of Dentistry, Seoul, Korea.
authors.forename: Young Hyun
authors.initials: YH
authors.lastname: Kim
authors.affiliation: Department of Oral and Maxillofacial Radiology, Yonsei University, College of Dentistry, Seoul, Korea.
authors.forename: Ji Yeon
authors.initials: JY
authors.lastname: Na
authors.affiliation: Department of Oral and Maxillofacial Radiology, Yonsei University, College of Dentistry, Seoul, Korea.
authors.forename: Sang-Sun
authors.initials: SS
authors.lastname: Han
keywords: Bisphosphonate-Associated Osteonecrosis of the Jaw; Osteoporosis; Risk Factors; Tooth Extraction