Anti-resorptive therapy in the osteometabolic patient affected by periodontitis. A joint position paper of the Italian Society of Orthopaedics and Traumatology (SIOT) and the Italian Society of Periodontology and Implantology (SIdP)

Journal of Orthopaedics and Traumatology

article

Landi, L.¹  Leali, P. Tranquilli³  Barbato, L.¹  Carrassi, A. M.¹  Discepoli, N.¹  Muti, P. C. M.¹  Oteri, G.¹  Rigoni, M.³  Romanini, E.³  Ruggiero, C.³  Tarantino, U.³  Varoni, E.¹  Sforza, N. M.¹  Brandi, M. L.³ 

[1] SIdP Panel;Private Practice Verona and Roma;SIOT Panel;Department of Orthopedic Diseases, University of Sassari;Department of Experimental and Clinical Medicine, Research Unit in Periodontology and Periodontal Medicine, University of Florence;Department of Biomedical, Surgical and Dental Sciences, University of Milan;Department of Medical Biotechnologies, Unit of Periodontology, University of Siena;Maxillo-Facial Surgery and Dental Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico;Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina;RomaPro;Department of Medicine and Surgery, Gerontology and Geriatric Section, University of Perugia;Department of Clinical Sciences and Translational Medicine, “Tor Vergata” University of Rome;Private Practice Bologna;Osservatorio Fratture da Fragilità

关键词: Anti-resorptive therapy;    Osteoporosis;    Periodontitis;    Periimplantitis;    MRONJ;   

DOI  :  10.1186/s10195-023-00713-7

学科分类：社会科学、人文和艺术（综合）

来源: Springer

【 摘 要 】

This joint report from the Italian Society of Orthopaedics and Traumatology (SIOT) and the Italian Society of Periodontology and Implantology (SIdP) aims for a consensus around the scientific rationale and clinical strategy for the management of osteoporotic patients affected by periodontitis who are undergoing anti-resorptive (AR) therapy to manage the risk of the occurrence of a medication-related osteonecrosis of the jaws (MRONJ). Osteoporosis and periodontitis are chronic diseases with a high prevalence in aging patients, and they share some of the same pathogenetic mechanisms based upon inflammation. Available evidence shows the relationship among osteoporosis, AR agents, periodontitis and implant therapy in relation to the incidence of MRONJ. Uncontrolled periodontitis may lead to tooth loss and to the need to replace teeth with dental implants. Tooth extraction and surgical dental procedures are recognized as the main risk factors for developing MRONJ in individuals taking AR therapy for osteometabolic conditions. Although the incidence of MRONJ in osteometabolic patients taking AR therapy may be as low as 0.9%, the increasing prevalence of osteoporosis and the high prevalence of periodontitis suggest that this potential complication should not be overlooked. Good clinical practice (GCP) guidelines are proposed that aim at a more integrated approach (prescriber, dentist, periodontist and dental hygienist) in the management of periodontitis patients undergoing AR therapy for osteometabolic disorders to reduce the risk of MRONJ. Dental professional and prescribers should educate patients regarding the potential risk associated with the long-term use of AR therapy and oral health behavior.

【 授权许可】

CC BY