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. 2021 Nov 1;26(6):e684-690.
doi: 10.4317/medoral.24007.

Medication related osteonecrosis of the jaws (MRONJ): Factors related to recurrence after treatment with surgery and platelet rich plasma (PRP) placement

C Sánchez-Gallego Albertos  1 , J-L Del Castillo Pardo de Vera, A Viejo Llorente, J-L Cebrián Carretero
Affiliations

Medication related osteonecrosis of the jaws (MRONJ): Factors related to recurrence after treatment with surgery and platelet rich plasma (PRP) placement

C Sánchez-Gallego Albertos et al. Med Oral Patol Oral Cir Bucal. .

Abstract

Background: Medication-related osteonecrosis of the jaws (MRONJ) is a well-known complication associated with antiresorptive and antiangiogenic therapies. The purpose of this study was to analyse if there is any predictive factor of recurrence after local debridement plus platelet rich plasma (PRP) placement in MRONJ patients.

Material and methods: Seventy MRONJ patients treated at the department of Oral and Maxillofacial Surgery in La Paz Hospital (Madrid, Spain) were included in this retrospective study. All of them were treated surgically by local debridement and PRP placement. The observation period was between January 2012 and January 2019. Information regarding use, type, administration, and duration of therapy with BP/denosumab was recorded. The follow-up period ranged from 2-52 months. A descriptive analysis, a bivariate and a multivariate study were performed.

Results: Most of the patients were women (82.9%) between 50-70 years old (64.3%), with a stage II disease (74.3%). The therapy lasted more than 12 months in 54.8% of them. Zoledronic acid was the main antiresorptive used (44.3%), followed by oral administered BPs (29 patients, 41.4%) and denosumab (10 patients, 14.3%). Osteoporosis (48.6%), breast cancer (30%) and multiple myeloma (11.4%) were the main diseases because the patients were taking antirresorptives. 13 patients (18.6%) experienced recurrence. We found that breast cancer patients (p>0.0001), smokers (p>0.016), and administration of zoledronic acid (p>0.0001) were related to recurrence. After performing the multivariate model, we found that the only factor related to recurrence was smoking habit (Wald 3.837, p=0.05, OR 6.12).

Conclusions: recurrence after local debridement plus PRP placement in our MRONJ series affected to 18.6% of patients. It seems to be more frequent in breast cancer patients, smokers, and after zoledronic acid administration. Smoking habit was the only independent factor related to recurrence in our series.

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Conflict of interest statement

Conflicts of interest The authors declare that they have no competing interests related to this study. No financial support was received.

References

    1. Marx R. Pamidronate (Aredia) and zoledronate (Zometa) induced avascular necrosis of the jaws: a growing epidemic. J Oral Maxillofac Surg. 2003;61:1115–7. - PubMed
    1. Marx R, Sawatari Y, Fortin M, Broumand V. Bisphosphonate-Induced Exposed Bone (Osteonecrosis/Osteopetrosis) of the Jaws: Risk Factors, Recognition, Prevention, and Treatment. J Oral Maxillofac Surg. 2005;63:1567–75. - PubMed
    1. Durie BG, Katz M, Crowley J. Osteonecrosis of the jaw and bisphosphonates. N Engl J Med. 2005;353:99–102. - PubMed
    1. Ruggiero SL, Dodson TB, Fantasia J, Goodday R, Aghaloo T, Mehrotra B. American Association of Oral and Maxillofacial Surgeons position paper on medication- related osteonecrosis of the jaw - 2014 update. J Oral Maxillofac Surg. 2014;72:1938–56. - PubMed
    1. Murphy J, Mannion CJ. Medication-related osteonecrosis of the jaws and quality of life: review and structured analysis. Br J Oral Maxillofac Surg. 2020;58:619–24. - PubMed

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