Evidence map›Paper›PMID 33997909›Full record

ArticleOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2021

Denosumab-related osteonecrosis of the jaw after tooth extraction and the effects of a short drug holiday in cancer patients: a multicenter retrospective study.

T Hasegawa, N Ueda, S I Yamada, S Kato, E Iwata, S Hayashida, Y Kojima, M Shinohara, I Tojo, H Nakahara and 7 more

Erratum issuedAbstract readMulticenter Study
PubMed Publisher
In one paragraph

Article in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 23 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
23citing papers in PubMed, 2 pooled it
2.5field-weighted citation impact, top 8% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

23 citing papers in PubMed, 2 syntheses or guidelines pooled it, 32 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. [Expert consensus on perioperative management of tooth extraction in patients receiving denosumab therapy].Hua xi kou qiang yi xue za zhi = Huaxi kouqiang yixue zazhi = West China journal of stomatology · 2026
    Article
  4. Article
  5. Article
  6. Article
  7. Review
  8. Article
  9. Review
  10. Article
  11. Article
  12. Article
  13. Review
  14. Review
  15. Review
  16. Article
  17. Article
  18. Review
  19. Article
  20. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

17 authors at 11 institutions in 1 country.

T HasegawaDepartment of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan. hasetaku@med.kobe-u.ac.jp.ORCID http://orcid.org/0000-0002-7349-7084
N UedaDepartment of Oral and Maxillofacial Surgery, Nara Medical University, Kashihara, Japan.
S I YamadaDepartment of Dentistry and Oral Surgery, Shinshu University School of Medicine, Matsumoto, Japan.
S KatoDepartment of Oral and Maxillofacial Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
E IwataDepartment of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.
S HayashidaDepartment of Clinical Oral Oncology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
Y KojimaDepartment of Dentistry and Oral Surgery, Kansai Medical University, Hirakata, Japan.
M ShinoharaDepartment of Oral and Maxillofacial Surgery, Juntendo University School of Medicine, Tokyo, Japan.
I TojoDepartment of Oral and Maxillofacial Surgery, Wakayama Medical University, Wakayama, Japan.
H NakaharaDepartment of Oral and Maxillofacial Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan.
T YamaguchiDepartment of Preventive Dentistry, Research Field in Dentistry, Medical and Dental Sciences Area, Kagoshima University, Kagoshima, Japan.
T KiritaDepartment of Oral and Maxillofacial Surgery, Nara Medical University, Kashihara, Japan.
H KuritaDepartment of Dentistry and Oral Surgery, Shinshu University School of Medicine, Matsumoto, Japan.
Y ShibuyaDepartment of Oral and Maxillofacial Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
S SoutomeDepartment of Oral Health, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
M AkashiDepartment of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.
Japanese Study Group of Co-operative Dentistry with Medicine (JCDM)
Kobe University · JPNagasaki University · JPNagoya City University · JPNara Medical University · JPShinshu University · JPJuntendo University · JPKagawa Prefectural Central Hospital · JPKagoshima University · JPKansai Medical University · JPOsaka City University · JPWakayama Medical University · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Pre-existing inflammation, corticosteroid therapy, periapical periodontitis, longer duration of denosumab therapy, and female sex were significantly associated with an increased risk of denosumab-related osteonecrosis of the jaw after tooth extraction in patients with cancer on oncologic doses of denosumab. A short drug holiday did not protect against this complication.

introductionThis study retrospectively investigated the relationship between various risk factors, including brief discontinuation of denosumab, and development of denosumab-related osteonecrosis of the jaw (DRONJ) after tooth extraction in patients with cancer who were receiving oncologic doses of this agent.

methodsData were collected on demographic characteristics, duration of denosumab therapy, whether or not denosumab was discontinued before tooth extraction (drug holiday), duration of discontinuation, presence of pre-existing inflammation, and whether or not additional surgical procedures were performed. Risk factors for DRONJ after tooth extraction were evaluated by univariate and multivariate analyses.

resultsA total of 136 dental extractions were performed in 72 patients (31 men, 41 women) with cancer who were receiving oncologic doses of denosumab. Post-extraction DRONJ was diagnosed in 39 teeth (28.7%) in 25 patients. Tooth extraction was significantly associated with development of DRONJ only in patients with pre-existing inflammation (odds ratio [OR] 243.77), those on corticosteroid therapy (OR 73.50), those with periapical periodontitis (OR 14.13), those who had been taking oncologic doses of denosumab for a longer period (OR 4.69), and in women (OR 1.04). There was no significant difference in the occurrence of DRONJ between patients who had a drug holiday before tooth extraction and those who did not.

conclusionsThese findings suggest that inflamed teeth should be extracted immediately in patients with cancer who are receiving oncologic doses of denosumab. Drug holidays have no significant impact on the risk of DRONJ.

Indexed as

Bisphosphonate-Associated Osteonecrosis of the JawBone Density Conservation AgentsNeoplasmsOsteonecrosisPharmaceutical PreparationsDenosumabDiphosphonatesFemaleHumansMaleRetrospective StudiesTooth ExtractionBone Density Conservation AgentsDenosumabDiphosphonatesPharmaceutical PreparationsDenosumabDenosumab-related osteonecrosis of the jawDiscontinuationDrug holidayMedication-related osteonecrosis of the jaw

Identifiers

PMID33997909
OpenAlexW3160719199

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.