Long waiting time before tooth extraction may increase delayed wound healing in elderly Japanese

The SummaryIn 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 2months was associated with an increased risk of delayed wound healing beyond 8weeks after extraction, a risk factor for developing ONJ.IntroductionA 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 8weeks after tooth extraction, which may be a risk factor of ONJ.MethodsOf 5639 patients aged 60years who visited our 20 clinics or hospitals and answered a structured questionnaire, 426 patients (151 men, 275 women) aged 60-96years 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 8weeks after tooth extraction during the past year based on the duration before extraction.ResultsSubjects who had waited >2months for tooth extraction had a significantly higher risk of delayed wound healing compared with those whose tooth was extracted within 1month (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).ConclusionsA long waiting time before tooth extraction may be a risk factor for delayed wound healing beyond 8weeks after extraction in patients aged 60years.