Clinical characteristics and recurrence-related factors of medication-related osteonecrosis of the jaw
- PMID: 30402414
- PMCID: PMC6209697
- DOI: 10.5125/jkaoms.2018.44.5.225
Clinical characteristics and recurrence-related factors of medication-related osteonecrosis of the jaw
Erratum in
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Corrigendum: Clinical characteristics and recurrence-related factors of medication-related osteonecrosis of the jaw.J Korean Assoc Oral Maxillofac Surg. 2018 Dec;44(6):302. doi: 10.5125/jkaoms.2018.44.6.302. Epub 2018 Dec 28. J Korean Assoc Oral Maxillofac Surg. 2018. PMID: 30637246 Free PMC article.
Abstract
Objectives: The purpose of this study was to investigate the demographic and clinical characteristics of patients with medication-related osteonecrosis of the jaw (MRONJ) and to elucidate factors affecting recurrence in surgical treatment.
Materials and methods: A total of 51 patients who were diagnosed with MRONJ were analyzed according to demographic and clinical features and treatment results through a retrospective chart review from 2013 to 2017 in the Department of Oral and Maxillofacial Surgery, Korea University Anam Hospital, Seoul in Korea.
Results: Alendronate composed the majority of medication doses (55.6%), followed by ibandronate (20.0%), risedronate (15.6%), and zoledronate (6.7%). Forty patients (88.9%) were given oral medication, and five patients (11.1%) were intravenously treated, and the mean duration of medication use was 61.1±42.9 months. A total of 10 patients (22.2%) had a drug holiday before MRONJ-induced dental treatment lasting an average of 6.8±7.0 months. MRONJ occurred 2.7 times more in the mandible, with 41 cases (73.2%) occurring in the mandible and 15 cases (26.8%) occurring in the maxilla, and the prevalence of affected posterior parts (premolar-molar) was six times greater than that of the anterior parts (incisor-canine) (48 cases vs 8 cases, 85.7% vs 14.3%). The most common dental cause of MRONJ was tooth extraction (69.6%). Regarding recurrence, there was no statistical difference in recurrence rate according to either site or stage. However, recurrence occurred in 4 out of 34 cases (11.8%) in the primary closure group and 9 out of 20 cases (45.0%) in the secondary healing group, and there was a statistical difference with respect to closure technique.
Conclusion: The identified risk factors in patients taking bone resorption inhibitors can aid dental clinicians in ensuring prevention and proper treatment of MRONJ.
Keywords: Bisphophonate-associated osteonecrosis of the jaw; Operative surgical procedure; Recurrence.
Conflict of interest statement
Conflict of Interest: No potential conflict of interest relevant to this article was reported.
References
-
- Ruggiero SL, Dodson TB, Fantasia J, Goodday R, Aghaloo T, Mehrotra B, et al. American Association of Oral and Maxillofacial Surgeons position paper on medication-related osteonecrosis of the jaw--2014 update. J Oral Maxillofac Surg. 2014;72:1938–1956. - PubMed
-
- Watts NB. Bisphosphonate treatment of osteoporosis. Clin Geriatr Med. 2003;19:395–414. - PubMed
-
- Nussbaum SR, Younger J, Vandepol CJ, Gagel RF, Zubler MA, Chapman R, et al. Single-dose intravenous therapy with pamidronate for the treatment of hypercalcemia of malignancy: comparison of 30-, 60-, and 90-mg dosages. Am J Med. 1993;95:297–304. - PubMed
-
- Berenson JR, Rosen LS, Howell A, Porter L, Coleman RE, Morley W, et al. Zoledronic acid reduces skeletal-related events in patients with osteolytic metastases. Cancer. 2001;91:1191–1200. - PubMed
-
- Black DM, Delmas PD, Eastell R, Reid IR, Boonen S, Cauley JA, et al. Once-yearly zoledronic acid for treatment of postmenopausal osteoporosis. N Engl J Med. 2007;356:1809–1822. - PubMed