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Tooth extraction is the major risk factor for development of MRONJ. Prevention including the maintenance of good oral hygiene, comprehensive dental examination and dental treatment including extraction of teeth of poor prognosis and dentoalveolar surgery should completed prior to commencing any medication which is likely to cause osteonecrosis ...
Pain, inflammation of the surrounding soft tissue, secondary infection or drainage may or may not be present. The development of lesions is most frequent after invasive dental procedures, such as extractions, and is also known to occur spontaneously. There may be no symptoms for weeks or months, until lesions with exposed bone appear. [5]
Dental disease and extractions; patients with poor oral hygiene and dental disease prior to radiation, including edentulous patients and those with dentures, are more susceptible to developing ORN. [ 3 ] [ 9 ] Diseased teeth near the radiation field may need to be extracted, [ 23 ] and should be evaluated prior to radiation treatment.
Socket preservation or alveolar ridge preservation is a procedure to reduce bone loss after tooth extraction. [1] [2] After tooth extraction, the jaw bone has a natural tendency to become narrow, and lose its original shape because the bone quickly resorbs, resulting in 30–60% loss in bone volume in the first six months. [3]
In order to obtain permission from patient for extraction of tooth, the dentist should explain that other treatment options are available, what is involved in the dental extraction procedure, the potential risks of the procedure and the benefits of the procedure. [2] The process of gaining consent should be documented in clinical notes. [2]
The menstrual cycle could be a determinant risk factor in the frequency of alveolar osteitis. Studies have shown that because of hormonal changes, women in the middle of menstrual cycle and the ones taking oral contraceptives (birth control pills) have a higher tendency of having alveolar osteitis after their tooth extraction surgery.
In relation with the first point of indication of the procedure, the bone contouring after dental extractions also helps in preparation for prosthetic rehabilitation. This serves as an important procedure as any sharp bony projections under removable appliances such as dentures will cause discomfort and pain when patient perform masticatory ...
Before starting bisphosphonate therapy, the person's dental health should be evaluated to assess the risk factors to prevent the development of medication-related osteonecrosis of the jaw (MRONJ). If there are any symptoms or radiographic appearance of MRONJ, such as jaw pain, loose tooth, or mucosal swelling, early referral to an oral surgeon ...