Evaluation of the relationship between bisphosphonate and denosumab use and external cervical resorption

Aim: To investigate the possibility of external cervical resorption in osteoporosis patients under bisphosphonate or denosumab treatment and to determine the period of use of the drug. Materials and Methods: A total of 90 adult patients receiving bisphosphonate or denosumab treatment, who applied to the Physical Therapy and Rehabilitation Department with the complaint of osteoporosis, participated in the study. Presence of systemic disease other than osteoporosis in the anamnesis, periodontal disease, orthodontic treatment, dental trauma and intracoronal bleaching history. The presence of jaw tumors, bruxism, viral infection and pregnant patients were excluded from the study. The patients were divided into two groups as those under bisphosphonate and denosumab drug therapy, and of 90 patients, 44 were in the bisphosphonate group and forty six were in the denosumab group drug therapy. The groups were divided into three subgroups according to the period of drug use: patients who have just started drug therapy, patients whose drug therapy continues, and patients whose drug therapy has been terminated. Intraoral examinations and radiographic examinations of the patients included in the study were performed in Endodontics AD. According to the examination findings, the regions where external cervical resorption was observed were recorded. The patients were called for 3-month follow-ups for two years. After taking panoramic and periapical radiography, cone-beam computed tomography was obtained from patients with suspected external cervical resorption. Results: ECR was found in 13 teeth of 7 patients out of 90 patients. There was no statistically significant difference in terms of ECR between the bisphosphonate and Denosumab groups (p=0.711). On the other hand, ECR was found to be higher in the patient group whose bisphosphonate treatment continued compared to the period of drug use (p=0.023). Conclusion: In patients using bisphosphonate and denosumab group drugs, tooth extraction should be avoided as much as possible due to the risk of medication-related osteonecrosis of the jaw (MRONJ) development in intraoral interventions. Early detection of ESR is important to avoid tooth extraction and traumatic surgical