[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-detail-56453-en":3,"doc-seo-56453-105":30,"detail-sidebar-cat-0-en-105":83},{"code":4,"msg":5,"data":6},0,"success",{"doc_id":7,"user_id":8,"nickname":9,"user_avatar":10,"doc_module":4,"category_id":11,"category_name":12,"doc_title":13,"doc_description":14,"doc_content":15,"file_id":16,"file_url":17,"file_type":18,"file_size":19,"view_count":20,"is_deleted":4,"is_public":21,"is_downloadable":21,"audit_status":21,"page_count":22,"language":23,"language_code":24,"site_id":25,"html_lang":24,"table_of_contents":26,"faqs":27,"seo_title":13,"seo_description":14,"update_tm":28,"read_time":29},56453,962075114765,"Quinn","https://ap-avatar.wpscdn.com/davatar_a8503ba1806abce46bf441b54a3ca4cd",7,"Healthcare","What Is the Risk of Developing Osteonecrosis Following Dental Extractions for Patients on Denosumab for Osteoporosis","Risk of osteonecrosis of the jaws (ONJ) is established for oral bisphosphonates (about 0.1–0.3%) but remains uncertain for osteoporosis patients receiving denosumab. A prospective cohort study followed consecutive patients on denosumab undergoing dental extractions (Jan 1, 2017–Jun 30, 2021) and compared outcomes with a control group not on antiresorptives. ONJ occurred in 10 of 427 patients (2.3%), with none in 299 controls. Extraction frequency and timing after injections increased ONJ risk.","PATHOLOGY  \nWhat is the Risk of Developing Osteonecrosis Following Dental Extractions for Patients on  \nDenosumab for Osteoporosis?  \nAnthony Colella, BDS,* Elaine Yu, BDS,y Paul Sambrook, MDS MBBS, z  \nToby Hughes, BAgSci, PhD, x and Alastair Goss, DDSck  \nPurpose: Osteonecrosis of the jaws (ONJ) occurs in patients on antiresorptive drugs for osteoporosis with the risk with oral bisphosphonates being known to be of the order of 0.1 to 0.3% while the risk for patients on denosumab for osteoporosis is not known.  \nThe aim of this study was to determine the risk of developing ONJ in a consecutive series of patients on denosumab for osteoporosis having dental extractions.  \nMaterial and Methods: A prospective cohort study of patients on denosumab for osteoporosis having dental extractions in the period January 1, 2017 and June 30, 2021 were compared to a control group not on antiresorptives. Detailed demographic records including length of time on antiresorptives and CTX values were obtained. Comparison to further define risk factors was made between those patients developing ONJ to those who didn’t.  \nResults: The treatment group included 427 patients who were on denosumab for osteoporosis; they collectively underwent 561 episodes of dental treatment involving extractions for a total of 1081 extractions, with 10 developing ONJ (risk 2.3%) . The control group consisted of 299 patients who were not taking denosumab; they collectively underwent 315 episodes of dental treatment for a total of 669 extractions, and none of them developed ONJ. There were significant differences in age and sex, but not medical comorbidities between the treatment and control groups. Within the treatment group, there were no significant differences in any of these characteristics between those who did, and those who didn’t, develop ONJ. Within the treatment group, the number of extractions modified the risk of developing ONJ (odds ratio, 1 . 35; confidence interval, 1 .1-1.7) . Of the 76 patients who had extractions between 6 and 7 months after the last denosumab injection, none developed ONJ.  \nConclusions: The risk of ONJ in patients on denosumab for osteoporosis is a magnitude greater than for patients on the oral bisphosphonates 2.3% v 0-0.3%, which is 7.7 times more likely. Number of extractionsand early resumption of the next dose of denosumab increases the risk of ONJ.  \n􀀁 2022 American Association of Oral and Maxillofacial Surgeons J Oral Maxillofac Surg 81:232-237, 2023  \n*Medical student, Medical School, The University of Adelaide, Adelaide, Australia.  \nyHouse Surgeon, Monash Medical Centre Clayton, Monash University, Melbourne, Australia.  \nzHead of Unit, Oral & Maxillofacial Surgery Unit, Adelaide, South Australia, Australia.  \nxProfessor and Postgraduate Coordinator, School of Dentistry, Faculty of Health Sciences, The University of Adelaide, Adelaide, South Australia, Australia.  \nkEmeritus Professor and Consultant, Oral & Maxillofacial Surgery Unit, The University of Adelaide, Adelaide, South Australia, Australia.  \nConflict of Interest Disclosures: None of the authors have any relevant financial relationship(s) with a commercial interest.  \nAddress correspondence and reprint requests to Dr Goss: Faculty of Health & Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia; e-mail: [alastair.goss@adelaide.edu.au](alastair.goss@adelaide.edu.au)[ ](alastair.goss@adelaide.edu.au)Received May 3 2022  \nAccepted October 27 2022  \n􀀁 2022 American Association of Oral and Maxillofacial Surgeons 0278-2391/22/00979-X  \n[https://doi.org/10.1016/j.joms.2022.10.014](https://doi.org/10.1016/j.joms.2022.10.014)  \nCOLELLA ET AL 233  \nDenosumab as a 60 mg subcutaneous injection (Prolia) has substantially replaced oral bisphosphonates as the first-line treatment for osteoporosis in Australia.1 Denosumab is a fully human monoclonal antibody to the receptor activator of nuclear factor kB ligand which is a member of the tumor necrosis factor re","cbCaimVMERgXdRBj","https://ap.wps.com/l/cbCaimVMERgXdRBj","pdf",226086,3,1,6,"English","en",105,"# Purpose\n# Material and Methods\n# Results\n# Conclusions","[{\"question\":\"What factors increased ONJ risk in the denosumab group?\",\"answer\":\"A higher number of extractions increased ONJ risk, and the study emphasizes that early resumption of the next denosumab dose and extraction-related timing relative to injections can raise risk.\"}]",1783893431,15,{"code":4,"msg":31,"data":32},"ok",{"site_id":25,"language":24,"slug":33,"title":13,"keywords":34,"description":14,"schema_data":35,"social_meta":78,"head_meta":80,"extra_data":82,"updated_unix":28},"what-is-the-risk-of-developing-osteonecrosis-following-dental-extractions-for-patients-on-denosumab-for-osteoporosis","",{"@graph":36,"@context":77},[37,53,68],{"@type":38,"itemListElement":39},"BreadcrumbList",[40,44,48,50],{"item":41,"name":42,"@type":43,"position":21},"https://docshare.wps.com","Home","ListItem",{"item":45,"name":46,"@type":43,"position":47},"https://docshare.wps.com/document/","Document",2,{"item":49,"name":12,"@type":43,"position":20},"https://docshare.wps.com/document/healthcare/",{"item":51,"name":13,"@type":43,"position":52},"https://docshare.wps.com/document/what-is-the-risk-of-developing-osteonecrosis-following-dental-extractions-for-patients-on-denosumab-for-osteoporosis/56453/",4,{"url":51,"name":13,"@type":54,"author":55,"headline":13,"publisher":57,"fileFormat":60,"inLanguage":24,"description":14,"dateModified":61,"datePublished":62,"encodingFormat":60,"isAccessibleForFree":63,"interactionStatistic":64},"DigitalDocument",{"name":9,"@type":56},"Person",{"url":41,"name":58,"@type":59},"DocShare","Organization","application/pdf","2026-07-20","2026-07-12",true,{"@type":65,"interactionType":66,"userInteractionCount":20},"InteractionCounter",{"@type":67},"ViewAction",{"@type":69,"mainEntity":70},"FAQPage",[71],{"name":72,"@type":73,"acceptedAnswer":74},"What factors increased ONJ risk in the denosumab group?","Question",{"text":75,"@type":76},"A higher number of extractions increased ONJ risk, and the study emphasizes that early resumption of the next denosumab dose and extraction-related timing relative to injections can raise risk.","Answer","https://schema.org",{"og:url":51,"og:type":79,"og:title":13,"og:site_name":58,"og:description":14},"article",{"robots":81,"canonical":51},"index,follow",{"doc_id":7,"site_id":25},{"code":4,"msg":5,"data":84},[85,89,93,97,102,106,109,114,119,122,126],{"id":21,"doc_module":4,"doc_module_name":46,"category_name":86,"show_sort_weight":87,"slug":88},"Story & Novel",90,"story-novel",{"id":47,"doc_module":4,"doc_module_name":46,"category_name":90,"show_sort_weight":91,"slug":92},"Literature",80,"literature",{"id":52,"doc_module":4,"doc_module_name":46,"category_name":94,"show_sort_weight":95,"slug":96},"Exam",70,"exam",{"id":98,"doc_module":4,"doc_module_name":46,"category_name":99,"show_sort_weight":100,"slug":101},5,"Comic",60,"comic",{"id":22,"doc_module":4,"doc_module_name":46,"category_name":103,"show_sort_weight":104,"slug":105},"Technology",50,"technology",{"id":11,"doc_module":4,"doc_module_name":46,"category_name":12,"show_sort_weight":107,"slug":108},40,"healthcare",{"id":110,"doc_module":4,"doc_module_name":46,"category_name":111,"show_sort_weight":112,"slug":113},8,"Research & Report",30,"research-report",{"id":115,"doc_module":4,"doc_module_name":46,"category_name":116,"show_sort_weight":117,"slug":118},9,"Religion & Spirituality",20,"religion-spirituality",{"id":117,"doc_module":4,"doc_module_name":46,"category_name":120,"show_sort_weight":117,"slug":121},"World Cup","world-cup",{"id":123,"doc_module":4,"doc_module_name":46,"category_name":124,"show_sort_weight":123,"slug":125},10,"Lifestyle","lifestyle",{"id":127,"doc_module":4,"doc_module_name":46,"category_name":128,"show_sort_weight":98,"slug":129},19,"General","general"]