A retrospective, single-center cohort study on complications after dental extractions in patients taking biologic agents

A retrospective, cross-sectional analysis of the dental status and needs of patients taking vascular endothelial growth factor (VEGF) antagonists

OBJECTIVES

There is growing literature related to the dental effects of biologic agents. However, little research has evaluated the dental needs of these patients and limited data is available on patients taking vascular endothelial growth factor (VEGF) antagonists.

MATERIALS AND METHODS

This retrospective cross-sectional study analyzed patients taking VEGF antagonists and their respective dental treatments from 2017 to 2023. Patient demographics, decayed, missing, and filled tooth (DMFT) status, and treatment details were recorded and evaluated descriptively. DMFT from this population was compared to patients taking other biologic agents using t-tests.

RESULTS

Twenty-three patients taking VEGF antagonists received dental treatment. Periodontal treatments were the most common (n = 18, 78%), followed by restorative treatments (n = 17, 74%). DMFT data for patients taking VEGF antagonists were not significantly different than values for patients taking other biologic agents, except for patients taking TNF-α Inhibitors, who had significantly fewer missing teeth than patients taking VEGF antagonists (3.88 vs. 8.10, p = 0.01).

CONCLUSIONS

The necessity of dental treatment in patients taking VEGF Antagonists is still unknown. Periodontal and restorative treatments were the most common modalities with no complications observed from treatment. While preventive periodontal treatment is routinely recommended, high usage of targeted periodontal and restorative treatments is seen in this population.

CLINICAL RELEVANCE

Minimal evidence exists to date on the delivery of and need for routine dental treatment among patients taking VEGF antagonists. This paper presents a first estimate of dental needs in this population.

What is the impact of biologics on the management of the oral surgery patient?

The use of biologics in medicine is on the rise. As dental professionals, it is becoming increasingly important that we are aware of this class of medications and the theoretical risks that they pose specific to the oral cavity to ensure safe delivery of dental treatment. This paper discusses some of these risks and recommendations to follow to manage patients undergoing oral surgery specifically.