1. Long waiting time before tooth extraction may increase delayed wound healing in elderly Japanese
- Author
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Masatoshi Komatsu, Akira Ichinose, Kenji Takahara, Hiroyuki Kato, Mikio Kamimura, Ryohei Ashizawa, Akira Taguchi, Hidefumi Koiwai, and Shigeharu Uchiyama
- Subjects
Male ,0301 basic medicine ,medicine.medical_specialty ,Time Factors ,Waiting Lists ,Endocrinology, Diabetes and Metabolism ,Osteoporosis ,Kyphosis ,Dentistry ,030209 endocrinology & metabolism ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Internal medicine ,medicine ,Humans ,Postoperative Period ,Risk factor ,Aged ,Aged, 80 and over ,Wound Healing ,Bone Density Conservation Agents ,business.industry ,Surrogate endpoint ,Odds ratio ,Middle Aged ,medicine.disease ,Confidence interval ,Rheumatology ,Tooth Extraction ,Spinal Fractures ,Bisphosphonate-Associated Osteonecrosis of the Jaw ,Female ,030101 anatomy & morphology ,Osteonecrosis of the jaw ,business ,Osteoporotic Fractures - Abstract
In osteoporosis patients receiving antiresorptive medications, stopping the drug and delaying tooth extraction has been suggested to reduce the risk of osteonecrosis of the jaw (ONJ). However, postponing tooth extraction for ≥ 2 months was associated with an increased risk of delayed wound healing beyond 8 weeks after extraction, a risk factor for developing ONJ. A long waiting time before tooth extraction could result from concern about a potential increased risk of osteonecrosis of the jaw (ONJ) in osteoporosis patients. We clarified whether a long waiting time before tooth extraction during the past year may be associated with an increased risk of delayed wound healing beyond 8 weeks after tooth extraction, which may be a risk factor of ONJ. Of 5639 patients aged ≥ 60 years who visited our 20 clinics or hospitals and answered a structured questionnaire, 426 patients (151 men, 275 women) aged 60–96 years comprised the final participants in this study. Self-reported kyphosis was used as a surrogate marker of vertebral fractures. Stepwise logistic regression analysis, adjusted for covariates, was used to calculate the odds ratio (OR) and the 95% confidence interval (CI) for the presence of delayed wound healing longer than 8 weeks after tooth extraction during the past year based on the duration before extraction. Subjects who had waited > 2 months for tooth extraction had a significantly higher risk of delayed wound healing compared with those whose tooth was extracted within 1 month (OR = 7.23; 95% CI = 2.19–23.85, p = 0.001) regardless if antiresorptive medications for osteoporosis were used. The presence of self-reported kyphosis was significantly associated with an increased risk of delayed wound healing (OR = 5.08; 95% CI = 1.11–23.32, p = 0.036). A long waiting time before tooth extraction may be a risk factor for delayed wound healing beyond 8 weeks after extraction in patients aged ≥ 60 years.
- Published
- 2018