Outcome of Initial NS-RCT in Patients with Anti-Resorptive or Anti-Angiogenesis Use

This retrospective cohort study aims to investigate the radiographic healing outcomes of non-surgical initial root canal treatment (NS-RCT) in patients using anti-resorptive or anti-angiogenic medications. Understanding the influence of these medications on the healing process is crucial for developing treatment strategies that mitigate the risk of medication-related osteonecrosis of the jaw (MRONJ). Dental records from the University of Illinois Chicago dental clinics were reviewed for patients who underwent NS-RCT from 1/1/2005 to 1/1/2020. Patients were categorized into two groups: an exposure group, which used anti-resorptive or anti-angiogenic medications, and a control group, which did not use these medications. Inclusion criteria required a minimum of one-year follow-up with periapical radiographs. Radiographic healing was assessed using modified periapical index (PAI) scores. Healing outcomes were classified as healed (PAI < 2), healing (PAI > 3 but with improvement), and non-healing (PAI ≥ 3 without improvement). Statistical analyses were performed using SPSS, with a significance level set at p < 0.05. A total of 215 unique patients, 83 in the intervention group and 132 in the control group, with 268 teeth met the inclusion criteria. The 1-year radiographic success rates were 91.8% for the exposure group and 92.5% for the control group, with no statistically significant difference (p = 0.513). No patients in the exposure group developed MRONJ following NS-RCT. NS-RCT appears to be a safe alternative to extraction in patients taking anti-resorptive or anti-angiogenic medications, with comparable radiographic healing outcomes to those not using these medications. Further research is needed to elucidate the specific mechanisms underlying this observation and to optimize treatment strategies for patients receiving these medications.