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Is implant surgery a risk factor for osteonecrosis of the jaw in older adult patients with osteoporosis? A national cohort propensity score-matched study

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Abstract
Objectives: This study aimed to investigate the association between dental implant
therapy and osteonecrosis of the jaw (ONJ) in osteoporotic patients and the relationship between tooth extraction, dental implantation, and ONJ.
Material and Methods: This retrospective cohort study used the Customized Health
Information Data from the National Health Insurance Corporation in South Korea.
The study population included patients older than 70 years with a history of osteoporosis; the cases included patients who had undergone dental implant surgery between July 2014 and July 2016 with specific procedure codes. The case and control
cohorts were stratified by tooth extraction because it was the strongest risk factor
to consider in this study. Each group of patients was matched using the propensity
score. To investigate the relationship between dental implants and ONJ, a Cox proportional hazard model was applied to socio-economic factors, comorbidities, and
bisphosphonates (BPs). All analyses were conducted using SAS statistical software.
Results: Based on the fully adjusted model, the propensity score-matched osteoporosis patients with dental implants had a 0.51 times hazard ratio of osteonecrosis. On
the contrary, tooth extraction was associated with a higher risk of ONJ (HR = 5.89).
The patients with rheumatoid arthritis (RA) and those using BPs had a higher HR,
respectively, 6.80 and 4.09 HR (p < .001).
Conclusions: Dental implantation was not a risk factor and patients with implants
show rather lower ratios. However, older osteoporotic Korean patients who had undergone tooth extraction had higher risks of ONJ. A significantly higher risk of ONJ
was associated with RA and BPs as well.
Author(s)
권용대김하영류재인
Issued Date
2021
Type
Article
Keyword
AgedAged patientsbisphosphonateBisphosphonate-Associated Osteonecrosis of the Jaw - epidemiologyBisphosphonate-Associated Osteonecrosis of the Jaw - etiologyBone Density Conservation AgentsBonesCohort StudiesComorbiditydental implantsDental Implants -adverse effectsDiphosphonatesHumansImplant denturesMedical researchMedicineExperimentalNational health insuranceNecrosisosteonecrosis of the jawOsteoporosisOsteoporosis - epidemiologyPropensity ScoreRepublic of Korea - epidemiologyRetrospective StudiesRheumatoid factorRisk FactorsSurgerytooth extraction
DOI
10.1111/clr.13713
URI
https://oak.ulsan.ac.kr/handle/2021.oak/7072
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_gale_infotracacademiconefile_A658633846&amp;context=PC&amp;vid=ULSAN&amp;lang=ko_KR&amp;search_scope=default_scope&amp;adaptor=primo_central_multiple_fe&amp;tab=default_tab&amp;query=any,contains,Is%20implant%20surgery%20a%20risk%20factor%20for%20osteonecrosis%20of%20the%20jaw%20in%20older%20adult%20patients%20with%20osteoporosis%3F%20A%20national%20cohort%20propensity%20score-matched%20study&amp;offset=0&amp;pcAvailability=true
Publisher
CLINICAL ORAL IMPLANTS RESEARCH
Location
미국
Language
영어
ISSN
0905-7161
Citation Volume
32
Citation Number
4
Citation Start Page
437
Citation End Page
447
Appears in Collections:
Medicine > Medicine
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