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Atraumatic tooth extraction in patients taking bisphosphonates: a review of literature and experience with three cases

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Abstract

Purpose

Regev et al. first re-introduced the method of atraumatic tooth extraction with orthodontic elastics in 2008. Since then, the method has been mentioned regularly in literature. Nevertheless, the need for additional more detailed information remains.

Methods

We present a review of literature and a retrospective analysis of our three patients receiving bisphosphonate medication. Two of our patients suffered from bisphosphonate-related osteonecrosis of the jaw (BRONJ). All three patients underwent atraumatic tooth extraction, which we describe in detail.

Results

Regev et al. reported satisfactory results using the novel method. We removed six teeth in two patients with continued chemotherapy or bisphosphonate therapy in a time span of 26.2 ± 16.4 weeks successfully. None of the patients developed exposed bone in the follow-up (7.4 ± 0.2 months). In one case, the technique had to be discontinued due to increasing tooth soreness.

Conclusions

Atraumatic tooth extraction seems to be a safe method to prevent bone exposure, even in cases with BRONJ. The time required of our patients for exfoliation exceeded the time mentioned in literature considerably. This proved to be a major limitation. Our cases showed that patients with good compliance, no sore teeth, or painful BRONJ lesions, benefited from atraumatic tooth extraction. One of the method’s major advantages might be the possibility to continue chemotherapy and bisphosphonate therapy throughout the treatment.

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Acknowledgments

We would like to thank Marlin Schmidt, MSc, Alberta, Canada, and Dr. Martin Widmann, MD, Germany, for proofreading this manuscript and their critical remarks. The authors declare that they have no conflicts of interest.

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Authors and Affiliations

  1. Department of Oral and Maxillofacial Surgery, University Hospital Tuebingen, Osianderstr. 2-8, 72076, Tuebingen, Germany

    Sebastian Hoefert, Martin Grimm, Michael Krimmel & Siegmar Reinert

  2. Department of Prosthodontics, University Hospital Tuebingen, Tuebingen, Germany

    Feraydoon Sharghi

  3. Department of Radiology, Center of Dentistry, Oral Medicine and Maxillofacial Surgery, University Hospital Tuebingen, Tuebingen, Germany

    Andreas Geist

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  1. Sebastian Hoefert
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Correspondence to Sebastian Hoefert.

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Hoefert, S., Grimm, M., Sharghi, F. et al. Atraumatic tooth extraction in patients taking bisphosphonates: a review of literature and experience with three cases. Oral Maxillofac Surg 18, 341–349 (2014). https://doi.org/10.1007/s10006-014-0452-7

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  • DOI: https://doi.org/10.1007/s10006-014-0452-7

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