ArticlePloS one2018
The influence of alendronate and tooth extraction on the incidence of osteonecrosis of the jaw among osteoporotic subjects.
Article in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it, 41 citations in OpenAlex.
- Risk of Osteonecrosis of the Jaw in Patients Treated with Zoledronic or Alendronic Acid: A Systematic Review.Medicina (Kaunas, Lithuania) · 2025Pooled it
- Incidence of osteonecrosis of the jaw in Japanese osteoporosis patients taking minodronic acid.Journal of bone and mineral metabolism · 2019Trial
- Estradiol replacement attenuates alendronate-associated adverse effects on alveolar bone repair in ovariectomized rats.Journal of periodontology · 2026Article
- Asia-Pacific consensus statement on medication-related osteonecrosis of the jaw in patients with osteoporosis.Osteoporosis and sarcopenia · 2026Review
- Clinical efficacy analysis of mucoperiosteal flap combined with perforation technique for tooth extraction in medication-related osteonecrosis of the jaw risk population: a retrospective study.BMC oral health · 2025Article
- Risk assessment and drug interruption guidelines for dentoalveolar surgery in patients with osteoporosis receiving anti-resorptive therapy.Journal of dental sciences · 2025Review
- Denosumab and clinical outcomes among men with osteoporosis: a retrospective cohort study.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2025Article
- Key insights into antiresorptive drug use and osteonecrosis in osteoporotic patients undergoing tooth extractions: A clinical and CBCT assessment.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2024Article
- Bisphosphonate-Related Osteonecrosis of the Jaw and Oral Microbiome: Clinical Risk Factors, Pathophysiology and Treatment Options.International journal of molecular sciences · 2024Review
- Pulp and periapical disease as a risk factor for osteonecrosis of the jaw: a national cohort-based study in Korea.Journal of periodontal & implant science · 2024Article
- Antibiotic prescription after tooth extraction in adults: a retrospective cohort study in Austria.BMC oral health · 2022Article
- Alendronate treatment in cats with persistent ionized hypercalcemia: A retrospective cohort study of 20 cases.Journal of veterinary internal medicine · 2022Article
- Use and risk of side effects of antiresorptive medication in people with intellectual disabilities.NIHR open research · 2022Article
- Morphological and immunohistochemical features of tooth extraction sites in rats treated with alendronate, raloxifene, or strontium ranelate.Clinical oral investigations · 2021Article
- Dual Delivery of Alendronate and E7-BMP-2 Peptide via Calcium Chelation to Mineralized Nanofiber Fragments for Alveolar Bone Regeneration.ACS biomaterials science & engineering · 2020Article
- Racial difference in bioavailability of oral ibandronate between Caucasian and Taiwanese postmenopausal women.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2020Article
- Current Understanding of the Pathophysiology of Osteonecrosis of the Jaw.Current osteoporosis reports · 2018Review
- Applications of Teriparatide for Alveolar Bone Regeneration: A Systematic Review.Journal of International Society of Preventive & Community DentistryReview
- Dental Hygienists' Awareness of Medication-Related Osteonecrosis of the Jaw in Private Dental Clinics in Japan.Gerontology & geriatric medicineArticle
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAlthough bisphosphonate-related osteonecrosis of the jaw (ONJ) develops mainly after tooth extractions (TEs), the strength of the association between them and how the existence of the disease among bisphosphonate (BP)-treated osteoporotic patients exposed to TE remain uncertain.
methodsA nationwide retrospective cohort study investigated the influence of alendronate and TE on the development of ONJ.
resultsIncidence of ONJ following long-term alendronate therapy was 262/100,000 person-years, while no event developed in the control group on raloxifene. Overall prevalence of ONJ in osteoporotic subjects receiving alendronate was estimated at 0.34% which rose to 2.16% after TE. Multiple logistic regression analysis, adjusted for the potential confounders, showed TE (adjusted odds ratio, 9.60 [4.33-21.29]), drug duration exceeding 3 years (3.00 [1.33-6.76]), and concomitant rheumatoid arthritis (4.94 [1.64-14.90]) were independent predictors of ONJ.
conclusionsThis article strengthens the relationship between ONJ and BPs. Among osteoporotic patients exposed to alendronate, TE confers a 9.6-fold increased risk for ONJ and it should be performed with caution irrespective of drug duration.
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