Effects of Denosumab-related Osteonecrosis of the jaw after
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This 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.

Demographic information, the length of denosumab treatment, whether or not denosumab was stopped before tooth extraction (drug holiday), the length of the drug holiday, the occurrence of pre-existing inflammation, and whether or not additional surgical procedures were performed were all gathered. Univariate and multivariate tests were used to assess risk factors for DRONJ after tooth extraction.

Results:
--A total of 136 dental extractions were performed in 72 patients with cancer who were receiving oncologic doses of denosumab.

--Post-extraction DRONJ was diagnosed in 39 teeth in 25 patients.

--Tooth extraction was significantly associated with development of DRONJ only in patients with pre-existing inflammation, those on corticosteroid therapy, those with periapical periodontitis, those who had been taking oncologic doses of denosumab for a longer period, and in women.

--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.

In conclusion, these results indicate that inflammed teeth in cancer patients receiving oncologic doses of denosumab should be extracted right away. Holidays from taking drugs have no effect on the risk of DRONJ.

Source: https://link.springer.com/article/10.1007/s00198-021-05995-3
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