ABSTRACT
ABSTRACT Objective: This study aimed to report the experience of medication-related osteonecrosis of the jaws (MRONJ) in osteoporotic patients for nine years, and their associated initiating factors. Materials and methods: The numbers of invasive oral procedures (IOP) (tooth extraction, dental implant placement, and periodontal procedures) and removable prostheses performed from January 2012 to January 2021 were obtained from the digital records of a large public dental center. There were an estimated 6,742 procedures performed in patients under osteoporosis treatment. Results: Two cases (0.03%) of MRONJ were registered in nine years amongst patients with osteoporosis who had dental treatment at the center. From the 1,568 tooth extractions, one patient (0.06%) developed MRONJ. There was also one case from the 2,139 removable prostheses delivered (0.05%). Conclusions: The prevalence of MRONJ associated with osteoporosis treatment was very low. The protocols adopted seem to be adequate for the prevention of this complication. The findings of this study reinforce the rare frequency of MRONJ associated with dental procedures in patients submitted to the pharmacological management of osteoporosis. An integral analysis of systemic risk factors and oral preventive strategies may be considered regularly in the dental treatment of these patients.
ABSTRACT
The maintenance of natural dentition under optimal function, health and aesthetics conditions is the main objective of dental treatments, but when therapeutic possibilities are exhausted, dental extractions become necessary. Bone remodeling due to post-extraction alveolar healing may result in volume changes in the region. This topic is common in renowned dentistry scientific publications and several researchers recommend tissue regenerative procedures and seek solutions minimize volume reduction. Among these procedures, the immediate installation of implants in post- extraction sockets without flap elevation is an alternative that guarantees functional and aesthetic benefits in the final result of the rehabilitation. This paper presents a clinical case that shows a practical and viable alternative therapy for adequate alveolar healing. In this clinical case, the use of immediate implants and personalized healing abutments with flowable resin composite reduced alveolar healing remodeling and allowed the preservation of the gingival architecture and to obtain an ideal emergency profile for performing the permanent prosthesis supported by implant.