SURGICAL APPROACH IN PATIENTS WHO ARE CANDIDATES FOR BPS THERAPY ON DENTAL ELEMENTS WITH UNCERTAIN PERIODONTAL PROGNOSIS: EVALUATION OF PI% AND BOP%

Periodontal disease is a risk factor for the development of bisphosphonate osteonecrosis; in fact, it is present in 84% of patients with osteonecrotic lesions. The aim is to provide the clinician with a diagnostic guide, through the application of the Plaque Index and Bleeding Index, to determine which patients are likely to be candidates for dental extractions prior to antiresorptive drug therapy in cases of elements that are periodontally compromised. The study was carried out by selecting sample subjects from the total pool of patients treated from 2010 to 2016 at the Operative Unit of Odontostomatology, Department of Oncologic Dentistry, IRCCS San Gerardo in Monza, Italy. Selected patients are placed within a protocol of professional oral hygiene sessions, during which their periodontal records are compiled. The results obtained from the study show that a low periodontal health condition, assessed by PI% and BoP%, out of which, however, only BoP% finds statistical significance, appears to be related to the risk of osteonecrosis. In conclusion, in this study, a threshold value of BoP% of 15% has been found. Below this value, the clinician can take into consideration, for dental elements with uncertain periodontal prognosis (fair or poor), a conservative or extractive treatment.