Risk factors of medication-related osteonecrosis of the jaw: a retrospective study in a Turkish subpopulation

Şahın, Onur; Odabaşı, Onur; Aliyev, Toghrul; Tatar, Birkan

doi:10.5125/jkaoms.2019.45.2.108

Cited by 14 publications

(15 citation statements)

References 25 publications

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“…Several factors such as therapeutic indication, drug type and duration, local, demographic, systemic and genetic factors have been mentioned in determining the incidence of MRONJ ( 4 ). Local etiologic factors that are effective in the development of MRONJ are defined as dentoalveolar surgical procedures, anatomical factors, prosthesis and associated local oral inflammatory diseases.…”

Section: Introductionmentioning

confidence: 99%

Prevention of medication related osteonecrosis of the jaw after dentoalveolar surgery: An institution’s experience

et al. 2020

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Background Dentoalveolar surgery is a predisposing factor for medication related osteonecrosis of the jaw (MRONJ). The aim of our study was to evaluate the described surgical procedures to prevent the development of MRONJ after dentoalveolar surgery in patients receiving bisphosphonates. Material and Methods In this retrospective study, sixty-three dentoalveolar surgeries were performed on 44 patients taking bisphosphonate in accordance with the treatment procedures we described. The following procedures were applied to patients 1) use of antibiotics 2) performed dentoalveolar surgical procedures 3) fill the socket with leukocyte- and platelet-rich fibrin (L-PRF) 4) post-operative application of low level laser therapy through Nd: YAG laser 5) sutures were removed on post-op 14th day 6) long-term results were evaluated. Results Healing of all patients was uneventful. Complete mucosal healing was achieved in all patients at 1 month. There is no failure was observed in long-term follow-up. Conclusions Because of the pathophysiology of MRONJ is not fully understood and has many risk factors, definitive protocols on prevention and treatment have not been established yet. Personal risk assessment is required for the prevention and treatment of MRONJ. The described surgical protocol may be considered to reduce the risk of developing MRONJ after dentoalveolar surgery due to its high success rate. Key words: Tooth extraction, medication related osteonecrosis of the jaw, preventive dentistry, L-PRF, low level laser therapy.

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Section: Introductionmentioning

confidence: 99%

Prevention of medication related osteonecrosis of the jaw after dentoalveolar surgery: An institution’s experience

et al. 2020

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“…In previous studies, oral health was a risk factor for MRONJ, and preventive measures must include dental consultation 4 , 5 , 11 . Other risk factors include inflammatory dental diseases, dental caries, torus mandibularis and palatinus, and traumatic factors such as unadapted dental prostheses 3 . Inflammation and bacterial infection are implicated in MRONJ pathogenesis 12 .…”

Section: Discussionmentioning

confidence: 99%

“… 2 Associations of zoledronic acid and trastuzumab (3), zoledronic acid and pamidronate (2), zoledronic acid and gefitinib (1). 3 Six patients started medication after consultation. …”

Section: Figmentioning

confidence: 99%

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Antiresorptive medication in oncology: the clinical and dental profile of patients in a reference center

Ferreira

Kemp

Vendruscolo

et al. 2021

JKAOMS

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Objectives: The aim of this study was to evaluate the profile of patients on antiresorptive therapies for cancer treatment and assess presence of oral lesions, oral hygiene status, and knowledge regarding medication-related osteonecrosis of the jaw (MRONJ). Materials and Methods: This was an observational cross-sectional study that evaluated patients treated with antiresorptive medication at a single cancer hospital. Clinical data were collected and oral examination was performed to assess patient oral health. Results: From July 2017 to December 2018, 90 patients were assessed; 64 were female and 26 were male, and the mean age was 61 years. The most common drug was an intravenous bisphosphonate, zoledronic acid. Among the 90 patients, 47 presented with some type of oral disease, isolated or associated. Among these 47 patients, 9 patients (10%) developed osteonecrosis. Oral hygiene was evaluated, and most patients, with or without MRONJ, presented with regular to poor condition. Regarding patient knowledge of the risks of MRONJ and the risks associated with dental surgery, 60% stated that they were not aware of the risks. Conclusion: Identifying the profile of patients and their needs facilitates not only the preventive process, but also the emergence of new therapeutic options. Our study shows that most patients are weakened both by metastatic disease and antineoplastic treatment as well as by issues associated with aging because most were over 60 years of age. Collectively, this information should be considered for management of preventive and therapeutic measures.

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“…A recognized risk factor for MRONJ is high concentration and long duration of BP intake [ 7 ]. The frequency of MRONJ in cancer patients has been estimated, ranging from 1% to 15%, while the frequency in patients with osteoporosis, receiving much lower BP doses, is estimated around 0.001% to 0.01% [ 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

Conservative Management of Medication-Related Osteonecrosis of the Jaws (MRONJ): A Retrospective Cohort Study

et al. 2021

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Background: Medication-related osteonecrosis of the jaw (MRONJ) is a severe side effect of bisphosphonates and anti-resorptive drugs prescribed for treatment of severe osteoporosis, Paget’s disease, and bone malignancies. The aim of this study was to evaluate the clinical outcome of a combined pharmacological and surgical management strategy on patients affected by MRONJ. Materials and methods: Medical records of patients with MRONJ were retrospectively examined to collect clinical history data. Conservative management included an initial pharmacological phase with antibiotics and antiseptic agents, followed by surgical intervention to remove bone sequestrum. Primary outcomes were healing from MRONJ at short term (1 month after surgery) and at longer term (3 months after surgery). Secondary outcome was assessment of recurrences at longer-term follow-up. Results: Thirty-five patients were included in the study with mean follow-up of 23.86 ± 18.14 months. Seven cases showed spontaneous exfoliation of necrotic bone during pharmacological therapy, which in one case did not require any further intervention. At 1-month posttreatment, 31 out of 35 (88.5%) patients showed complete healing. The 25 patients who were followed for at least 3 months revealed a healing rate of 92% (23/25). Recurrences occurred in 7 patients out 23 who showed the long-term healing, after a mean period of 7.29 ± 3.45 months. The prognostic score (University of Connecticut Osteonecrosis Numerical Scale—UCONNS) was significantly higher (p = 0.01) in patients with poor healing as compared to complete healing, both at 1 and 3 months posttreatment. Conclusions: A MRONJ treatment approach based on a combined pharmacological and surgical treatment strategy showed a high rate of healing and few recurrences.

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Risk factors of medication-related osteonecrosis of the jaw: a retrospective study in a Turkish subpopulation

Cited by 14 publications

References 25 publications

Prevention of medication related osteonecrosis of the jaw after dentoalveolar surgery: An institution’s experience

Prevention of medication related osteonecrosis of the jaw after dentoalveolar surgery: An institution’s experience

Antiresorptive medication in oncology: the clinical and dental profile of patients in a reference center

Conservative Management of Medication-Related Osteonecrosis of the Jaws (MRONJ): A Retrospective Cohort Study

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