Evidence map›Paper›PMID 40601030›Full record

ArticleJournal of bone and mineral metabolism2025

What is the appropriate antibiotic administration to prevent MRONJ development after tooth extraction?

Eiji Iwata, Hiroaki Ohori, Yuriko Susukida, Nanae Yatagai, Masahiko Kashin, Taiki Matsui, Naoki Takata, Masaki Kobayashi, Daisuke Miyai, Akira Tachibana and 1 more

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In one paragraph

Article in Journal of bone and mineral metabolism, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from 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.

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

11 authors.

Eiji IwataDepartment of Oral and Maxillofacial Surgery, Kakogawa Central City Hospital, 439 Hon-machi, Kakogawa-cho, Kakogawa, 675-8611, Japan. iwataeiji19851126@gmail.com.
Hiroaki OhoriDepartment of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
Yuriko SusukidaDepartment of Oral and Maxillofacial Surgery, Kakogawa Central City Hospital, 439 Hon-machi, Kakogawa-cho, Kakogawa, 675-8611, Japan.
Nanae YatagaiDepartment of Oral and Maxillofacial Surgery, Kakogawa Central City Hospital, 439 Hon-machi, Kakogawa-cho, Kakogawa, 675-8611, Japan.
Masahiko KashinDepartment of Oral and Maxillofacial Surgery, Kakogawa Central City Hospital, 439 Hon-machi, Kakogawa-cho, Kakogawa, 675-8611, Japan.
Taiki MatsuiDepartment of Oral and Maxillofacial Surgery, Kakogawa Central City Hospital, 439 Hon-machi, Kakogawa-cho, Kakogawa, 675-8611, Japan.
Naoki TakataDepartment of Oral and Maxillofacial Surgery, Hyogo Prefectural Awaji Medical Center, Awaji, Japan.
Masaki KobayashiDepartment of Oral and Maxillofacial Surgery, Shin-Suma General Hospital, Kobe, Japan.
Daisuke MiyaiDepartment of Oral and Maxillofacial Surgery, Nishiwaki Municipal Hospital, Nishiwaki, Japan.
Akira TachibanaDepartment of Oral and Maxillofacial Surgery, Kakogawa Central City Hospital, 439 Hon-machi, Kakogawa-cho, Kakogawa, 675-8611, Japan.
Masaya AkashiDepartment of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThere are no established guidelines for antibiotic administration to prevent the development of medication related-osteonecrosis of the jaw (MRONJ) after tooth extraction in patients receiving antiresorptive agents (ARAs). Since 2022, the duration of antibiotic administration during extractions in such patients has been intentionally shortened to prevent antimicrobial resistance at our hospitals.

methodsThis retrospective study involved 160 patients on low-dose bisphosphonates (BPs) requiring tooth extractions between 2019 and 2024 at four Japanese institutions. In 2019-2021, patients received amoxicillin (AMPC) 500 mg 1 h before and 750 mg per day for 2 days post-extraction. In 2022-2024, a single 500 mg dose of AMPC was administered 1 h pre-extraction. Patients were managed with tension-free wound suturing and regular follow-up. The rates of MRONJ development were compared between the two periods.

resultsMRONJ developed in 3 out of 170 teeth (1.76%) in 2019-2021, and in 2 out of 147 teeth (1.36%) in 2022-2024, with no significant difference (P = 1.000). All MRONJ cases were low-stage (Stage 1) and healed completely within 12-16 weeks. Four out of five MRONJ cases (80%) exhibited radiopaque changes around the root. When all teeth in both groups were surveyed, MRONJ development was significantly higher in teeth with such changes compared to those without (4/58 vs. 1/259; P = 0.004).

conclusionA single preoperative dose of AMPC may be sufficient for tooth extractions in patients on low-dose BPs. However, teeth with radiopaque changes around the root require careful monitoring postextraction.

Indexed as

Anti-Bacterial AgentsBisphosphonate-Associated Osteonecrosis of the JawTooth ExtractionAdultAgedAged, 80 and overAmoxicillinFemaleHumansMaleMiddle AgedRetrospective StudiesAmoxicillinAnti-Bacterial AgentsAntibiotic administrationBisphosphonatesMedication related osteonecrosis of the jawRadiopaque changes around the rootTooth extraction

Identifiers

PMID40601030
PMCPMC12620319

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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.