Clinical characteristics and recurrence-related factors of medication-related osteonecrosis of the jaw.
10.5125/jkaoms.2018.44.5.225
- Author:
Mong Hun KANG
1
;
Dong Keon LEE
;
Chang Woo KIM
;
In Seok SONG
;
Sang Ho JUN
Author Information
1. Department of Oral and Maxillofacial Surgery, Korea University Anam Hospital, Seoul, Korea. sis80@naver.com, junsang@korea.ac.kr
- Publication Type:Original Article
- Keywords:
Bisphophonate-associated osteonecrosis of the jaw;
Operative surgical procedure;
Recurrence
- MeSH:
Alendronate;
Bone Density Conservation Agents;
Holidays;
Humans;
Jaw*;
Korea;
Mandible;
Maxilla;
Osteonecrosis*;
Prevalence;
Recurrence;
Retrospective Studies;
Risedronate Sodium;
Risk Factors;
Seoul;
Surgery, Oral;
Surgical Procedures, Operative;
Tooth Extraction
- From:Journal of the Korean Association of Oral and Maxillofacial Surgeons
2018;44(5):225-231
- CountryRepublic of Korea
- Language:English
-
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.
