Evidence map›Paper›PMID 41366443›Full record

ArticleOrphanet journal of rare diseases2025

Potential role of the comprehensive tooth extraction procedure in preventing medication related osteonecrosis of the jaw (MRONJ): a prospective cohort study.

Yi Wang, Yu Zhang, Dengke Li, Wuyang Zhang, Shuming Wang, Xueni Zheng, Yuan Li, Tiange Deng, Chunlin Zong, Lei Tian and 2 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Orphanet journal of rare diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Yi Wang *State Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, School of Stomatology, National Clinical Research Center for Oral Diseases, The Fourth Military Medical University, Xi'an, Shaanxi, China.
Yu Zhang *State Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, School of Stomatology, National Clinical Research Center for Oral Diseases, The Fourth Military Medical University, Xi'an, Shaanxi, China.
Dengke LiDepartment of Stomatology, Air Force Hospital of Southern Theater Command, Guangzhou, China.
Wuyang ZhangState Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, School of Stomatology, National Clinical Research Center for Oral Diseases, The Fourth Military Medical University, Xi'an, Shaanxi, China.
Shuming WangState Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, School of Stomatology, National Clinical Research Center for Oral Diseases, The Fourth Military Medical University, Xi'an, Shaanxi, China.
Xueni ZhengState Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, School of Stomatology, National Clinical Research Center for Oral Diseases, The Fourth Military Medical University, Xi'an, Shaanxi, China.
Yuan LiState Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, School of Stomatology, National Clinical Research Center for Oral Diseases, The Fourth Military Medical University, Xi'an, Shaanxi, China.
Tiange DengState Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, School of Stomatology, National Clinical Research Center for Oral Diseases, The Fourth Military Medical University, Xi'an, Shaanxi, China.
Chunlin ZongState Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, School of Stomatology, National Clinical Research Center for Oral Diseases, The Fourth Military Medical University, Xi'an, Shaanxi, China.
Lei TianState Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, School of Stomatology, National Clinical Research Center for Oral Diseases, The Fourth Military Medical University, Xi'an, Shaanxi, China.
Ping LiuState Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, School of Stomatology, National Clinical Research Center for Oral Diseases, The Fourth Military Medical University, Xi'an, Shaanxi, China. lp-212@sohu.com.
Yang XueState Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, School of Stomatology, National Clinical Research Center for Oral Diseases, The Fourth Military Medical University, Xi'an, Shaanxi, China. xueyangfmmu@163.com.ORCID 0000-0002-7804-5730

Funding

State Key Laboratory for Advanced Metals and Materials 2024MS06
6 · The paper itself

Abstract

backgroundThis article aims to elucidate the potential role of a comprehensive tooth extraction procedure in preventing mdication-related osteonecrosis of the jaw (MRONJ) through a prospective cohort study. By systematically assessing clinical outcomes following this procedure, the study seeks to provide evidence regarding its effectiveness in MRONJ prevention, thereby contributing to improved clinical guidelines and patient care related to dental extractions in at-risk populations.

methodsPatients using anti-resorptive agents (ARAs) who required extraction of at least one tooth were included in the study. Patients' medical history, medication history, and intraoral dental conditions were documented, and CBCT scans were performed. Following a standardized treatment protocol, patients received professional oral cleaning and antibiotics preoperatively. During surgery, minimally invasive extraction and concentrated growth factor (CGF) filling were performed with meticulous suturing whenever possible. Postoperatively, mouthwash was used within one month. Follow-up visits were scheduled at 10, 30, and 90 days to monitor and analyze MRONJ incidence and surgical outcomes.

resultsA total of 101 patients were included in the study, with 20 receiving oral ARAs for osteoporosis, 57 receiving intravenous ARAs for osteoporosis, 13 undergoing combination therapy for osteoporosis, and 11 using ARAs for malignancy. Zoledronic acid and denosumab were the most commonly used drugs. Increased bone density was observed on preoperative CBCT in 26 patients, and on postoperative CBCT at 90 days in 31 patients. In total, 248 teeth were extracted, mostly due to severe defects; periapical periodontitis and periodontitis were also major reasons for extraction. Most patients could not achieve complete and tight suturing. All patients remained free of MRONJ during the 90‑day postoperative period, with complete mucosal healing in every case.

conclusionThis prospective cohort study provides evidence that implementing an effective and rational treatment protocol during tooth extractions significantly benefits high-risk MRONJ patients. Adherence to such protocols minimizes the risk of postoperative infection, fosters improved healing of extraction sites, and maximizes the prevention of MRONJ. CLINICAL TRIAL NUMBER: Not applicable.

Indexed as

Bisphosphonate-Associated Osteonecrosis of the JawTooth ExtractionAgedAged, 80 and overBone Density Conservation AgentsFemaleHumansMaleMiddle AgedProspective StudiesBone Density Conservation AgentsConcentrated growth factor (CGF)Medication-related osteonecrosis of the jaw (MRONJ)Perioperative careTooth extraction

Identifiers

PMID41366443
PMCPMC12690952

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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.