Journal of Oral and Maxillofacial Surgery
Volume 66, Issue 6 , Pages 1157-1161, June 2008

Atraumatic Teeth Extraction in Bisphosphonate-Treated Patients

  • Eran Regev, DMD, MD

      Affiliations

    • Lecturer and Attending, Department of Oral and Maxillofacial Surgery, Hadassah–Hebrew University Medical Center and Faculty of Dental Medicine, Jerusalem, Israel.
    • Corresponding Author InformationAddress correspondence and reprint requests to Dr Regev: Department of Oral and Maxillofacial Surgery, Hadassah–Hebrew University Faculty of Dental Medicine, PO Box 12272, Jerusalem, 91120, Israel
    • ,
  • Joshua Lustmann, DMD

      Affiliations

    • Professor and Attending, Department of Oral and Maxillofacial Surgery, Hadassah–Hebrew University Medical Center and Faculty of Dental Medicine, Jerusalem, Israel.
    • ,
  • Rizan Nashef, DMD

      Affiliations

    • Resident, Department of Oral and Maxillofacial Surgery, Hadassah–Hebrew University Medical Center and Faculty of Dental Medicine, Jerusalem, Israel.

Purpose

The purpose of this study was to suggest an alternative technique for atraumatic teeth extraction that would prevent bone exposure and the associated complication of osteonecrosis of the jaws in bisphosphonate (BP)–treated patients, without terminating the treatment.

Patients and Methods

A total of 10 patients treated with BPs for multiple myeloma, metastatic breast cancer, and osteoporosis, requiring dental extractions of nontreatable teeth, were included in this study. The extractions were performed by means of orthodontic elastics placed around the roots, causing slow and gradual exfoliation of the teeth.

Results

The technique was applied to 21 roots of 15 teeth. A total of 19 roots exfoliated spontaneously. Two roots had to be removed with minimal manipulation by forceps. The mean time required for exfoliation was 5.8 weeks. All sockets showed soft tissue secondary healing and there were no signs of inflammation or exposed bone during the 9-month follow-up.

Conclusions

Atraumatic extraction by use of elastics is a safe technique that may be used in BP-treated patients to prevent osteonecrosis of the jaws.

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PII: S0278-2391(08)00222-X

doi:10.1016/j.joms.2008.01.059

Journal of Oral and Maxillofacial Surgery
Volume 66, Issue 6 , Pages 1157-1161, June 2008

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