Affiliation:
1. Kobe University Graduate School of Medicine
Abstract
Abstract
Medication-related osteonecrosis of the jaw (MRONJ) is a severe adverse effect of antiresorptive and/or antiangiogenic agents. The standard treatment for MRONJ is conservative treatment and a surgical approach; however, its application remains controversial. This study aimed to identify the risk factors for poor prognosis and to help determine appropriate management. We retrospectively investigated factors associated with the prognosis of MRONJ in 119 patients. Relevant clinical data were obtained for all the patients. In computed tomography images, osteosclerosis, osteolysis, cortical perforation (buccal or lingual), periosteal reaction, and sequestration were observed. Univariate and multivariate analyses were used to evaluate the risk factors for poor prognosis. Multivariate analyses showed statistically significant associations between poor prognosis in patients with MRONJ and conservative treatment alone (hazard ratio [HR] 1.89), osteolysis (HR 4.67), and the absence of sequestration (HR 5.33). These results suggest that conservative treatment alone without clear objectives should be avoided, and osteolytic change could be the criteria for surgical intervention. As the boundary between the lesion and vital bone is indistinct, we recommend extensive surgery in cases which sequestration is unpredictable.
Publisher
Research Square Platform LLC