Comparing the Influence of Surgical and Conservative Therapy on Quality of Life in Patients with Early-Stage Medication-Related Osteonecrosis of the Jaw—A Prospective Longitudinal Study

Abstract

Background and Objectives: The purpose of this study was to evaluate the impact of surgical and conservative, non-surgical treatment on general health-related (QoL) and oral health-related quality of life (OHRQoL) in patients suffering from AAOMS stage I MRONJ. Materials and Methods: In the course of this prospective clinical study, QoL and OHRQoL using QLQ-C30 and QHIP G14 questionnaire were longitudinally assessed in N= 174 prospectively enrolled patients with indication of treatment of MRONJ stage I over a period of 12 months. Patients received conservative or surgical treatment. The measurement time points were preoperatively (T0), 12 weeks (T1), 6 months (T2) and 1 year after operation (T3). Results: For OHRQoL, no significant (p > 0.05) differences were found between both treatment groups for all timepoints (T0–T3). In the surgical treatment group, OHIP scores of T1, T2 and T3 were significantly lower than baseline measures (T0) (T0–T1 (2.99, p = 0.024), T0–T2 (5.20, p < 0.001), T0–T3 (7.44, p < 0.001)). For conservative treatment group OHIP, scores of T2 and T3 were significantly lower than baseline measures (T0) (T0–T2 (9.09, p = 0.013), T0–T3 (12.79, p < 0.001)). There was no statistically significant effect of time on QLQ-C30 scores in both groups (surgical treatment: F(3, 174) = 1.542, p < 0.205, partial η² = 0.026; conservative treatment: F(3, 30) = 0.528, p = 0.667, partial η² = 0.050). QLQ-C30 scores turned out to be significantly lower in the non-surgical group at T1 (p = 0.036) and T3 (p = 0.047) compared to the surgical treatment group. Conclusions: Surgical and conservative treatment of MRONJ stage I significantly improves patients’ OHRQoL. Surgical treatment is superior to conservative treatment of MRONJ stage I regarding general QoL. Therefore, surgical treatment of MRONJ stage I should not be omitted for QoL reasons.

Oral health‐related quality of life among women early postpartum: A cross‐sectional study

“…17,19 It is also noteworthy that new recommendations regarding the best measures that should be utilized for the OHRQoL dimensions have been mentioned in the literature. Recently, John et al 25,26 reclassified the OHRQoL dimensions and recommended that 4 dimensions Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact (corresponding to Physical Disability, Physical Pain, Psychological Discomfort, and Handicap domains, respectively) should be preferably used to reflect the impact on the OHRQoL, accompanied by a summary score derived from all the OHIP questionnaire items (i.e., OHIP-49, OHIP-14, etc.). We performed additional supplementary analyses using this recent 4-dimensional characterization of the OHRQoL as per the recommendations of John et al 25 These additional supplementary analyses (see Tables S1 and S2 in online Journal of Periodontology) showed no significant differences in the OHRQoL between mothers with normal/low and high OIL.…”

“…It is also noteworthy that new recommendations regarding the best measures that should be utilized for the OHRQoL dimensions have been mentioned in the literature. Recently, John et al 25,26 . reclassified the OHRQoL dimensions and recommended that 4 dimensions Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact (corresponding to Physical Disability, Physical Pain, Psychological Discomfort, and Handicap domains, respectively) should be preferably used to reflect the impact on the OHRQoL, accompanied by a summary score derived from all the OHIP questionnaire items (i.e., OHIP‐49, OHIP‐14, etc.).…”

Comparison of Different Antibiotic Regimes for Preventive Tooth Extractions in Patients with Antiresorptive Intake—A Retrospective Cohort Study

“…With better knowledge of the problems involved, minimization of the risk of medication-related osteonecrosis of the jaw (MRONJ) in patients receiving antiresorptive (AR) therapy is becoming increasingly relevant [ 1 , 2 , 3 , 4 ]. The time window of prevention (defined as risk reduction during/after AR therapy) is especially important, not only because the most uncertainty about the optimal course of action occurs during this period, but also because a differential diagnostic challenge between preventive measures must be faced.…”