Acute periapical abscesses may be a risk factor for medication-related osteonecrosis of the jaw.

PURPOSE: To explore the potential association between acute periapical abscesses (PAs) and medication-related osteonecrosis of the jaw (MRONJ). The study assessed the risk for MRONJ in patients seeking emergency dental treatment for acute PAs in a large medical facility in the United States.

METHODS

Data aggregated from 1,799,122 patients visiting a large medical center were recorded. Data from the corresponding diagnosis codes for MRONJ and acute PAs was retrieved by searching the appropriate query in the database. The odd ratio of acute PAs and their association with MRONJ were calculated and analyzed statistically.

RESULTS

Patients with PAs showed significantly more MRONJ cases. The odds ratio (OR) of patients receiving all types of bisphosphonates (BPs) was 6.21 and was statistically significant (P< 0.0001). The OR of patients receiving alendronate was 5.33 and was statistically significant (P= 0.0001). Following adjustment for diabetes co-morbidity, the OR for MRONJ patients with acute PAs was 5.33. The difference in prevalence compared to the total hospital patient population was statistically significant (P= 0.0001). Following adjustment for smoking co-morbidity, the OR for MRONJ in patients with acute PAs was 4.44. The difference in prevalence as compared to the total hospital patient population was statistically significant (P= 0.001).

CLINICAL SIGNIFICANCE: Oral healthcare providers should be aware of the possible association between MRONJ and the higher occurrence of acute periapical abscesses. Enhanced oral hygiene and frequent dental visits are recommended to diagnose and treat dental pathoses promptly in MRONJ patients.