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Atraumatic tooth extraction in patients taking bisphosphonates: a review of literature and experience with three cases.
MedLine Citation:
PMID:  24827755     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
PURPOSE: Regev et al. first re-introduced the method of atraumatic tooth extraction with orthodontic elastics in 2008. Since then, the method has been mentioned regularly in literature. Nevertheless, the need for additional more detailed information remains.
METHODS: We present a review of literature and a retrospective analysis of our three patients receiving bisphosphonate medication. Two of our patients suffered from bisphosphonate-related osteonecrosis of the jaw (BRONJ). All three patients underwent atraumatic tooth extraction, which we describe in detail.
RESULTS: Regev et al. reported satisfactory results using the novel method. We removed six teeth in two patients with continued chemotherapy or bisphosphonate therapy in a time span of 26.2 ± 16.4 weeks successfully. None of the patients developed exposed bone in the follow-up (7.4 ± 0.2 months). In one case, the technique had to be discontinued due to increasing tooth soreness.
CONCLUSIONS: Atraumatic tooth extraction seems to be a safe method to prevent bone exposure, even in cases with BRONJ. The time required of our patients for exfoliation exceeded the time mentioned in literature considerably. This proved to be a major limitation. Our cases showed that patients with good compliance, no sore teeth, or painful BRONJ lesions, benefited from atraumatic tooth extraction. One of the method's major advantages might be the possibility to continue chemotherapy and bisphosphonate therapy throughout the treatment.
Authors:
Sebastian Hoefert; Martin Grimm; Feraydoon Sharghi; Andreas Geist; Michael Krimmel; Siegmar Reinert
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-5-15
Journal Detail:
Title:  Oral and maxillofacial surgery     Volume:  -     ISSN:  1865-1569     ISO Abbreviation:  Oral Maxillofac Surg     Publication Date:  2014 May 
Date Detail:
Created Date:  2014-5-15     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101319632     Medline TA:  Oral Maxillofac Surg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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