Biological Therapy and Oral Surgery: Safety Recommendations and Practices

Abstract

The integration of biological therapies, including biologics and biosimilars, into the medical practice has transformed the management of numerous chronic inflammatory, autoimmune, and oncological conditions. However, these treatments can pose challenges in oral and maxillofacial surgery due to their potential effects on wound healing, infection risk, and immune responses. This article reviews the most commonly used biological agents and provides safety recommendations for managing patients on biological therapies undergoing oral surgical procedures, such as tooth extractions (including multiple and surgical extractions), implant placement, periodontal and soft tissue surgeries, and the removal of non-cancerous or cancerous growths in the oral cavity. Key considerations include the oral complications associated with biologic treatments, preoperative risk assessment, perioperative timing of biologic administration, and postoperative monitoring to minimize complications. While several professional organizations have issued recommendations on the perioperative management of biological agents, there is currently no specific guidance tailored to dental or oral surgical procedures. This paper aims to explore the existing literature and recommendations regarding the use of biologics in the perioperative period.