Risk factors associated with onset of medication-related osteonecrosis of the jaw in patients treated with denosumab

OBJECTIVES While risk factors of bisphosphonate (BP) associated osteonecrosis of the jaw have been properly analyzed, studies focusing on risk factors associated with denosumab (DNO) are sparse. The purpose of this study was to identify risk factors influencing the onset of medication-related osteonecrosis of the jaw (MRONJ) in patients receiving antiresorptive treatment (ART) with DNO by comparing patients suffering from MRONJ and patients without MRONJ. Multiple variables were evaluated including the impact of a previous BP intake. MATERIALS AND METHODS A retrospective single-center cohort study with patients receiving DNO was conducted. One-hundred twenty-eight patients were included and divided into three groups: I (control, n = 40) receiving DNO with absence of MRONJ; group II (Test 1, n = 46), receiving DNO with presence of MRONJ; and group III (Test 2, n = 42) sequentially receiving BP and DNO with presence of MRONJ. Patients' medical history, focusing on the identification of MRONJ risk factors, was collected and evaluated. Parameters were sex, age, smoking habit, alcohol consumption, underlying disease (cancer type, osteoporosis), internal diseases, additional chemo/hormonal therapy, oral inflammation, and trauma. RESULTS The following risk factors were identified to increase MRONJ onset significantly in patients treated with DNO: chemo/hormonal therapy (p = 0.02), DNO dosage (p < 0.01), breast cancer (p = 0.03), intake of corticosteroids (p = 0.04), hypertension (p = 0.02), diabetes mellitus (p = 0.04), periodontal disease (p = 0.03), apical ostitis (p = 0.02), and denture use (p = 0.02). A medication switch did not affect MRONJ development (p = 0.86). CONCLUSIONS Malignant diseases, additional chemotherapy, DNO dosage, and oral inflammations as well as diabetes mellitus and hypertension influence MRONJ onset in patients treated with DNO significantly. CLINICAL RELEVANCE Patients receiving ART with DNO featuring aforementioned risk factors have a higher risk of MRONJ onset. These patients need a sound and regular prophylaxis in order to prevent the onset of MRONJ under DNO treatment

A dental myth bites the dust - no observable relation between the incidence of dental abscess and the weather and lunar phase: an ecological study

Background: Anecdotal reports assert a relationship between weather and lunar activity and the odontogenic abscess (OA) incidence, but this relationship has not been validated. Therefore, the present study investigated the relationship between oral pain caused by OA and a variety of meteorological parameters and cyclic lunar activity. Methods: The records of all dental emergency patients treated at the AllDent Zahnzentrum Emergency Unit in Munich, Germany during 2012 were retrospectively reviewed. Patients with oral pain who were diagnosed with OA and treated surgically (n = 1211) were included in the analysis. The OA incidence was correlated to daily meteorological data, biosynoptic weather analysis, and cyclic lunar activity. Results: There was no seasonal variation in the OA incidence. None of the meteorological parameters, lunar phase, or biosynoptic weather class were significantly correlated with the OA incidence, except the mean barometric pressure, which was weakly correlated (rho = -0.204). The OA incidence showed a decreasing trend as barometric pressure increased (p < 0.001). On multiple linear regression, the barometric pressure accounted for approximately 4% of the OA incidence. Conclusion: There is no evidence supporting a correlation between the incidence of odontogenic abscess and the weather and lunar activities

Therapeutic elastic tape reduces morbidity after wisdom teeth removal—a clinical trial

ObjectivesAlthough the extraction of an impacted third molar (3M) is a routine procedure, postoperative morbidities typically include swelling, pain, and trismus. The aim of the present study was to investigate whether the application of kinesiologic tape can improve the postoperative morbidities associated with 3M surgery, thereby improving the postoperative well-being of patients.Materials and methodsForty patients assigned for prospective 3M removal were randomized into two treatment groups (with/without kinesiologic tape). Facial swelling was quantified using a five-line measurement at six specific time points. Pain scores were assessed using a visual analog scale, and mouth opening range was assessed by means of standard calipers. In addition, all patients were asked to evaluate overall satisfaction and swelling (both groups) and the effect of the tape on movement and comfort (taped group only).ResultsThe postoperational application of kinesiologic tape reduced significantly all investigated parameters: swelling, pain, and trismus. Furthermore, patients with kinesiologic tape reported a significantly lower morbidity rate.ConclusionThe application of kinesiologic tape following a 3M surgery is a simple and economical, yet medically relevant approach.Clinical relevanceKinesiologic tape offers patients a less traumatic postoperational experience and therefore holds promise to enhance the quality of life of a large cohort of the population