A Clinical Retrospective Study of Surgical Treatment for Medication-Related Osteonecrosis of the Jaw

Sukegawa, Shintaro; Kanno, Takahiro; Kawai, Hiroki; Nakamura, Satoko; Shibata, Aya; Sukegawa‐Takahashi, Yuka; Nagatsuka, Hitoshi; Furuki, Yoshihiko

doi:10.2485/jhtb.25.447

Cited by 6 publications

(3 citation statements)

References 31 publications

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“…On the other hand, in Japan, a revised position paper which was issued in 2016 by the five Society (the Japanese Society for Bone and Mineral Research, the Japan Osteoporosis Society, the Japanese Society for Oral and Maxillofacial Radiology, the Japanese Society of Periodontology, and the Japanese Society of Oral and Maxillofacial Surgeons) recommends surgical treatments such as bone removal, curettage of necrotic bone, and bone resection from Stage 2. Some papers had reported effectiveness of surgical treatment and recommended surgical treatment for MRONJ [4][5][6] . However there is no concerted consciousness on the treatment methods of MRONJ patients in the pres-ent.…”

Section: Introductionmentioning

confidence: 99%

Prognosis of Medication-Related Osteonecrosis of the Jaw with Surgical Treatment

Kobayashi

Takahashi

Igarashi

et al. 2022

J. Hard Tissue Biology.

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In 2014, the American Association of Oral and Maxillofacial Surgery (AAOMS) recommended surgical treatment for medication-related osteonecrosis of the jaw (MRONJ) patients classified as Stage 3. In 2016, the Japanese position paper recommended surgical treatment classified as Stage 2. Some systematic review reported effectiveness of surgical treatment for MRONJ. However there is no concerted consciousness on the treatment methods of MRONJ patients in the present. This study aimed to retrospectively elucidate clinical outcomes of the surgical treatment of MRONJ patients under the same criteria. This study included 86 patients in 40 osteoporosis patients (5 men and 35 women, average age: 78.8 years) and 46 cancer patients (18 men and 28 women, average age: 67.7 years). The outcome was classified into two categories: Healing or No healing in each stage. Among 86 patients, MRONJ was found in 91 jaws, of which 69 jaws (75.8%) were surgically operated. Total healing rate of surgical treatment was 85.5%, and total healing rate of conservative treatment was 4.5%. It was suggested that surgical treatment for MRONJ had a high clinical response rate in all stages.

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Section: Introductionmentioning

confidence: 99%

Prognosis of Medication-Related Osteonecrosis of the Jaw with Surgical Treatment

Kobayashi

Takahashi

Igarashi

et al. 2022

J. Hard Tissue Biology.

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“…Bone-modifying agents (BMA) such as bisphosphonates (BP) and denosumab (DMAb) are used to prevent osteoporotic fractures, bone metastases, and bone-related events in multiple myeloma. However, since the first case of BP-related osteonecrosis of the jaw was described by Marx in 2003 [ 1 ], cases of anti-resorptive agent-related osteonecrosis of the jaw (ARONJ) have been commonly reported [ 2 , 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

Incidence and Risk of Anti-Resorptive Agent-Related Osteonecrosis of the Jaw after Tooth Extraction: A Retrospective Study

Shimizu

Sukegawa

et al. 2022

Healthcare

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Bone-modifying agents (BMA) such as bisphosphonates and denosumab are frequently used for the treatment of bone metastases, osteoporosis, and multiple myeloma. BMA may lead to anti-resorptive agent-related osteonecrosis of the jaw (ARONJ). This study aimed to clarify the risk factors for and probabilities of developing ARONJ after tooth extraction in patients undergoing BMA therapy. In this study, the records of 505 target sites of 302 patients undergoing BMA who presented with mandibular fractures at the Department of Oral and Maxillofacial Surgery, Kagawa Prefectural Central Hospital, from March 2014 to January 2022, were retrospectively analyzed for the onset of ARONJ after tooth extraction. The following variables were investigated as attributes: anatomy, health status, and dental treatment. The correlation coefficient was calculated for the success or failure of endodontic surgery for each variable, the odds ratio was calculated for the upper variable, and the factors related to the onset of ARONJ were identified. The incidence rate of ARONJ was found to be 3.2%. Hypoparathyroidism was an important factor associated with ARONJ development. Thus, systemic factors are more strongly related to the onset of ARONJ after tooth extraction than local factors.

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“…However, anti-receptor activator of nuclear factor κB ligand (RANKL) antibody preparations, which are classified as bone resorption inhibitors, and bisphosphonates have been shown to cause osteonecrosis of the jaw (ONJ) (5)(6)(7). Thus, the term antiresorptive agent-related ONJ (ARONJ) was adopted (8).…”

Section: Introductionmentioning

confidence: 99%

Relationship between oral condition and risk factors for jaw osteonecrosis in patients with hip fractures

et al. 2020

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Purpose : Antiresorptive agents, such as bisphosphonates, are useful for the prevention of the recurrence of hip fractures. However, their administration has a risk of antiresorptive agent-related osteonecrosis of the jaw (ARONJ), and risk factors include poor oral hygiene. It is difficult for an orthopedic surgeon to examine a patient's oral condition thoroughly. This study evaluated the relationship between risk factors for ARONJ and intraoral findings in hip fracture patients. Materials and Methods : We evaluated 79 patients (average age of 82.2 years) with hip fracture surgery who underwent an oral assessment by dentists. The risk assessments of the intraoral findings were classified into four levels (levels 0-3), with levels 2 and 3 requiring dental treatment intervention. Data that could be extracted as risk factors of ARONJ were also examined. Results : Level 1 was found most frequently (54.4%), followed by level 0 (35.4%), level 2 (8.9%), level 3 (1.3%). The area under the receiver operating characteristic curve for the number of risk factors for the two groups (dental treatment intervention required and unnecessary) and oral findings were 0.732. When the cut-off value was set to two risk factors, the specificity and sensitivity was 53.5% and 87.5%. Conclusions : For hip fracture patients with a more than 2 risk factors, dental visits are recommended to prevent ARONJ. This is a useful evaluation method that can be used to screen for ONJ from data obtained from other risk factors, even if it is difficult to evaluate the oral condition in hospitals where dentists are absent.

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A Clinical Retrospective Study of Surgical Treatment for Medication-Related Osteonecrosis of the Jaw

Cited by 6 publications

References 31 publications

Prognosis of Medication-Related Osteonecrosis of the Jaw with Surgical Treatment

Prognosis of Medication-Related Osteonecrosis of the Jaw with Surgical Treatment

Incidence and Risk of Anti-Resorptive Agent-Related Osteonecrosis of the Jaw after Tooth Extraction: A Retrospective Study

Relationship between oral condition and risk factors for jaw osteonecrosis in patients with hip fractures

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