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Objective: To assess the clinical features of exodontias performed in cancer patients who have been receiving
intravenous bisphosphonates (BPs).
Study Design: This is a retrospective cohort study using a sample of 20 patients receiving BPs who had 62 teeth
extracted. An univariate analysis was applied to calculate socket healing time (HT), comparing among exodontias
performed according to cause, such as periodontal disease or caries, type of BP, and use of corticosteroid. In order
to analyze the influence of each variable on HT, multiple statistical analyses were performed through logistic
multiple regression.
Results: From the 62 tooth extractions performed, 5 exodontias had evolved to 4 sites of bisphosphonate-related
osteonecrosis of the jaws (BOJ). Of another 57 exodontias without development of BOJ, HT was significantly
better for tooth extraction performed in patients receiving corticosteroid (p= .01), for tooth extracted due to caries
(p= .04), and for extractions under pamidronate (p= .03). Sockets after exodontias due to periodontal diseases
had OR= 5.22 (95% CI 1.73-133.66, p=0.01) for delayed HT, exodontias performed under corticosteroid use had
OR=0.04 (95% CI 0.01-0.40, p<0.001), and exodontias performed under zoledronate had OR=0.31 (95% CI 0.08-
1.25, p=0.10).
Conclusions: Exodontias performed in patients under BP therapy had a low rate of BOJ occurrence. Zoledronate
and periodontal diseases influence delayed socket healing. Adjuvant antibiotics could be relevant procedures
aimed at reducing the risk of BOJ development.
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