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Kammerhofer G, Vegh D, Bányai D, Végh Á, Joob-Fancsaly A, Hermann P, Geczi Z, Hegedus T, Somogyi KS, Bencze B, Biczó Z, Juhász DH, Zaborszky P, Ujpál M, Vaszilkó MT, Németh Z. Association between Hyperglycemia and Medication-Related Osteonecrosis of the Jaw (MRONJ). J Clin Med 2023; 12:jcm12082976. [PMID: 37109314 PMCID: PMC10144577 DOI: 10.3390/jcm12082976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 04/12/2023] [Accepted: 04/18/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND Medication-related osteonecrosis of the jaw (MRONJ) is a type of jawbone necrosis caused by the use of drugs for some types of cancer and osteoporosis. The current study aimed to evaluate the associations between hyperglycemia and the development of medication-related osteonecrosis of the jaw. METHODS Our research group investigated data collected between 1 January 2019 and 31 December 2020. A total of 260 patients were selected from the Inpatient Care Unit, Department of Oromaxillofacial Surgery and Stomatology, Semmelweis University. Fasting glucose data were used and included in the study. RESULTS Approximately 40% of the necrosis group and 21% of the control group presented with hyperglycemia. There was a significant association between hyperglycemia and MRONJ (p < 0.05, p = 0.003). Vascular anomaly and immune dysfunction caused by hyperglycemia can lead to necrosis after tooth extraction. Necrosis is more common in the mandible (75.0%) and in the case of parenteral antiresorptive treatment (intravenous Zoledronate and subcutaneous Denosumab). Hyperglycemia is a more relevant risk factor than bad oral habits (26.7%). CONCLUSIONS Ischemia is a complication of abnormal glucose levels, a possible risk factor for necrosis development. Hence, uncontrolled or poorly regulated plasma glucose levels can significantly increase the risk of jawbone necrosis after invasive dental or oral surgical interventions.
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Affiliation(s)
- Gabor Kammerhofer
- Department of Oromaxillofacial Surgery and Stomatology, Semmelweis University, 1088 Budapest, Hungary
- Diabetes-Dental Working Group, Semmelweis University, 1088 Budapest, Hungary
| | - Daniel Vegh
- Diabetes-Dental Working Group, Semmelweis University, 1088 Budapest, Hungary
- Department of Prosthodontics, Semmelweis University, 1088 Budapest, Hungary
| | - Dorottya Bányai
- Diabetes-Dental Working Group, Semmelweis University, 1088 Budapest, Hungary
- Department of Paediatric Dentistry and Orthodontics, Semmelweis University, 1088 Budapest, Hungary
| | - Ádám Végh
- Diabetes-Dental Working Group, Semmelweis University, 1088 Budapest, Hungary
- Department of Oral Diagnostics, Semmelweis University, 1088 Budapest, Hungary
| | - Arpad Joob-Fancsaly
- Department of Oromaxillofacial Surgery and Stomatology, Semmelweis University, 1088 Budapest, Hungary
- Diabetes-Dental Working Group, Semmelweis University, 1088 Budapest, Hungary
| | - Peter Hermann
- Diabetes-Dental Working Group, Semmelweis University, 1088 Budapest, Hungary
- Department of Prosthodontics, Semmelweis University, 1088 Budapest, Hungary
| | - Zoltan Geczi
- Diabetes-Dental Working Group, Semmelweis University, 1088 Budapest, Hungary
- Department of Prosthodontics, Semmelweis University, 1088 Budapest, Hungary
| | - Tamas Hegedus
- Diabetes-Dental Working Group, Semmelweis University, 1088 Budapest, Hungary
- Department of Prosthodontics, Semmelweis University, 1088 Budapest, Hungary
| | - Kata Sara Somogyi
- Diabetes-Dental Working Group, Semmelweis University, 1088 Budapest, Hungary
- Department of Prosthodontics, Semmelweis University, 1088 Budapest, Hungary
| | - Bulcsú Bencze
- Diabetes-Dental Working Group, Semmelweis University, 1088 Budapest, Hungary
- Department of Prosthodontics, Semmelweis University, 1088 Budapest, Hungary
| | - Zita Biczó
- Department of Oromaxillofacial Surgery and Stomatology, Semmelweis University, 1088 Budapest, Hungary
- Diabetes-Dental Working Group, Semmelweis University, 1088 Budapest, Hungary
| | - Donát Huba Juhász
- Diabetes-Dental Working Group, Semmelweis University, 1088 Budapest, Hungary
- Faculty of Dentistry, Semmelweis University, 1088 Budapest, Hungary
| | - Péter Zaborszky
- Diabetes-Dental Working Group, Semmelweis University, 1088 Budapest, Hungary
- Faculty of Dentistry, Semmelweis University, 1088 Budapest, Hungary
| | - Márta Ujpál
- Department of Oromaxillofacial Surgery and Stomatology, Semmelweis University, 1088 Budapest, Hungary
- Diabetes-Dental Working Group, Semmelweis University, 1088 Budapest, Hungary
| | - Mihály Tamás Vaszilkó
- Department of Oromaxillofacial Surgery and Stomatology, Semmelweis University, 1088 Budapest, Hungary
- Diabetes-Dental Working Group, Semmelweis University, 1088 Budapest, Hungary
| | - Zsolt Németh
- Department of Oromaxillofacial Surgery and Stomatology, Semmelweis University, 1088 Budapest, Hungary
- Diabetes-Dental Working Group, Semmelweis University, 1088 Budapest, Hungary
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Végh D, Bencze B, Banyai D, Vegh A, Rózsa N, Nagy Dobó C, Biczo Z, Kammerhofer G, Ujpal M, Díaz Agurto L, Pedrinaci I, Peña Cardelles JF, Magrin GL, Padhye NM, Mente L, Payer M, Hermann P. Preoperative HbA1c and Blood Glucose Measurements in Diabetes Mellitus before Oral Surgery and Implantology Treatments. Int J Environ Res Public Health 2023; 20:4745. [PMID: 36981651 PMCID: PMC10048655 DOI: 10.3390/ijerph20064745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 02/27/2023] [Indexed: 06/18/2023]
Abstract
Diabetes mellitus has become a worldwide epidemic and is frequently accompanied by a number of complications proportional to the duration of hyperglycemia. The aim of this narrative review is to assess the most up-to-date guidelines on DM provided by both diabetes and dental associations. Furthermore, to gather evidence on the uni/bidirectional relationships of elevated HbA1c levels on dental surgery, implantology, bone augmentation, and periodontology and to demonstrate the importance of measuring HbA1c levels before invasive dental treatments. HbA1c and blood glucose measurements are a minimally invasive method for preventing complications in diabetes mellitus. The authors conducted a literature review to determine which oral conditions are affected by diabetes mellitus. MEDLINE served as a source with the use of a specific search key. Regarding oral complications of diabetes, prevention is the most vital factor. With this publication, we hope to assist physicians and dentists to make prompt diagnoses and to help in recognizing various oral manifestations of diabetes and follow the existing guidelines.
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Affiliation(s)
- Dániel Végh
- Department of Prosthodontics, Semmelweis University, 1088 Budapest, Hungary
- Division of Oral Surgery and Orthodontics, Department of Dentistry and Oral Health, Medical University of Graz, Billrothgasse 4, 8010 Graz, Austria
| | - Bulcsú Bencze
- Department of Prosthodontics, Semmelweis University, 1088 Budapest, Hungary
| | - Dorottya Banyai
- Department of Pedodontics and Orthodontics, Semmelweis University, 1088 Budapest, Hungary
| | - Adam Vegh
- Department of Oral Diagnostics, Semmelweis University, 1088 Budapest, Hungary
| | - Noémi Rózsa
- Department of Pedodontics and Orthodontics, Semmelweis University, 1088 Budapest, Hungary
| | - Csaba Nagy Dobó
- Department of Oral Diagnostics, Semmelweis University, 1088 Budapest, Hungary
| | - Zita Biczo
- Department of Maxillofacial and Oral Surgery, Semmelweis University, 1088 Budapest, Hungary
| | - Gabor Kammerhofer
- Department of Maxillofacial and Oral Surgery, Semmelweis University, 1088 Budapest, Hungary
| | - Marta Ujpal
- Department of Maxillofacial and Oral Surgery, Semmelweis University, 1088 Budapest, Hungary
| | - Leonardo Díaz Agurto
- Faculty of Dentistry, Postgraduate School, Universidad de Chile, Santiago 7520355, Chile
- Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Centre, Johannes Gutenberg-University, 55131 Mainz, Germany
| | - Ignacio Pedrinaci
- Section of Graduate Periodontology, Faculty of Dentistry, Complutense University of Madrid, 28040 Madrid, Spain
- Department of Restorative Dentistry and Biomaterials Science, Harvard School of Dental Medicine, Harvard University, Boston, MA 02115, USA
| | - Juan Francisco Peña Cardelles
- Science Committee for Antibiotic Research of Spanish Society of Implants (SEI—Sociedad Española de Implantes), 28020 Madrid, Spain
- Department of Basic Health Sciences, Rey Juan Carlos University, 28922 Madrid, Spain
- Oral and Maxillofacial Surgery Department, School of Dental Medicine, University of Connecticut Health, Farmington, CT 06030, USA
| | - Gabriel Leonardo Magrin
- Section of Graduate Periodontology, Faculty of Dentistry, Complutense University of Madrid, 28040 Madrid, Spain
- Center for Education and Research on Dental Implants (CEPID), Department of Dentistry, Federal University of Santa Catarina (UFSC), 88040-900 Florianopolis, Brazil
| | - Ninad Milind Padhye
- Centre for Oral Clinical Research, Queen Mary University and The London School of Medicine and Dentistry, The Royal London Dental Hospital, London E1 1FR, UK
| | - Laura Mente
- Division of Oral Surgery and Orthodontics, Department of Dentistry and Oral Health, Medical University of Graz, Billrothgasse 4, 8010 Graz, Austria
| | - Michael Payer
- Division of Oral Surgery and Orthodontics, Department of Dentistry and Oral Health, Medical University of Graz, Billrothgasse 4, 8010 Graz, Austria
| | - Peter Hermann
- Department of Prosthodontics, Semmelweis University, 1088 Budapest, Hungary
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Vegh A, Banyai D, Ujpal M, Somogyi KS, Biczo Z, Kammerhofer G, Nemeth Z, Hermann P, Payer M, Vegh D. Prevalence of Diabetes and Impaired Fasting Glycemia in Patients With Oral Cancer: A Retrospective Study in Hungary. Anticancer Res 2022; 42:109-113. [PMID: 34969716 DOI: 10.21873/anticanres.15464] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 10/21/2021] [Accepted: 10/25/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM Diabetes mellitus (DM) is one of the most common chronic metabolic disorders. Our research aimed to demonstrate the relationship between DM and oral cancer. PATIENTS AND METHODS We pursued a retrospective research study in Hungary between January 2019 and December 2020. We investigated 597 inpatient records and compared them to the results of our previous studies (1998-2002 and 2012-2015). RESULTS The frequency of patients with DM in the oral cancer group is 2.45 times higher today than 20 years ago. The prevalence rate of DM and oral malignancies increased from 14.6% to 35.8%. In the oral cancer group, 54.4% of the patients had elevated blood glucose levels and of these, 61.1% of them had type 2 diabetes, 34.2% had impaired fasting glycemia, and only 4.7% had type 1 diabetes. We observed that 45.3% of them were smokers. Of those whose blood sugar levels were under 6.1 mmol/l, the mean body mass index was 25.33 [standard deviation (SD)=±4.5; range=15.57-39.84], while among patients with DM, it was 26.92 (SD=±5.8; range=18.36-44.08). CONCLUSION It may be necessary to continuously monitor the patient's blood sugar level to maintain euglycemic levels when managing patients with malignant oral lesions.
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Affiliation(s)
- Adam Vegh
- Department of Maxillofacial and Oral Surgery, Semmelweis University, Budapest, Hungary.,Diabetes-Dental Working Group, Semmelweis University, Budapest, Hungary
| | - Dorottya Banyai
- Diabetes-Dental Working Group, Semmelweis University, Budapest, Hungary.,Department of Pedodontics and Orthodontics, Semmelweis University, Budapest, Hungary
| | - Marta Ujpal
- Department of Maxillofacial and Oral Surgery, Semmelweis University, Budapest, Hungary.,Diabetes-Dental Working Group, Semmelweis University, Budapest, Hungary
| | - Kata Sara Somogyi
- Diabetes-Dental Working Group, Semmelweis University, Budapest, Hungary.,Faculty of Dentistry, Dental Student, Semmelweis University, Budapest, Hungary
| | - Zita Biczo
- Diabetes-Dental Working Group, Semmelweis University, Budapest, Hungary.,Faculty of Dentistry, Dental Student, Semmelweis University, Budapest, Hungary
| | - Gabor Kammerhofer
- Diabetes-Dental Working Group, Semmelweis University, Budapest, Hungary.,Faculty of Dentistry, Dental Student, Semmelweis University, Budapest, Hungary
| | - Zsolt Nemeth
- Department of Maxillofacial and Oral Surgery, Semmelweis University, Budapest, Hungary
| | - Peter Hermann
- Department of Prosthodontics, Semmelweis University, Budapest, Hungary
| | - Michael Payer
- Diabetes-Dental Working Group, Semmelweis University, Budapest, Hungary.,Division of Oral Surgery and Orthodontics, Department of Dental Medicine and Oral Health, School of Dentistry, Medical University Graz, Graz, Austria
| | - Daniel Vegh
- Diabetes-Dental Working Group, Semmelweis University, Budapest, Hungary .,Department of Prosthodontics, Semmelweis University, Budapest, Hungary
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