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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 ...
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 decaying tooth root provides bacteria with an enclosed environment with low oxygen content. Consequently, the obligate and facultative anaerobes present within the oral cavity flourish and outcompete the other bacteria at the site of tooth decay, causing the dental caries to escalate into a mouth infection.
The most common location of dry socket: in the socket of an extracted mandibular third molar (wisdom tooth). Since alveolar osteitis is not primarily an infection, there is not usually any pyrexia (fever) or cervical lymphadenitis (swollen glands in the neck), and only minimal edema (swelling) and erythema (redness) is present in the soft tissues surrounding the socket.
Today, however, the condition is often a hidden infection, due in part to not being visible on most dental X-rays unless there is a substantial loss of bone density. In addition, some schools of dentistry do not recognize "silent" OM of the jaws—occurrence of the condition without visually obvious manifestations—in their curriculum.
An oroantral fistula (OAF) is an epithelialized oroantral communication (OAC), which refers to an abnormal connection between the oral cavity and the antrum. [1] The creation of an OAC is most commonly due to the extraction of a maxillary tooth (typically a maxillary first molar) which is closely related to the antral floor.