A Single Reference Center, 2 Years Retrospective Study on the Risk Factors Associated With Anti-Resorptive Medication-Related Osteonecrosis of the Jaws in Osteoporotic and Oncological Patients

Abstract

Medication-related osteonecrosis of the jaws (MRONJ) has multiple exogenous and endogenous risk factors. The risk of MRONJ associated with anti-resorptive drugs (Bisphosphonates and Denosumab) was reviewed in oncological and osteoporotic patients referred to the Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome (Italy), since January 2019 to January 2021. The incidence of MRONJ was analyzed according to local (dental extraction), systemic risk factors (diabetes, steroid, ecc), medication type, and drug treatment duration. The intake of Zolendronate was strongly associated with osteonecrosis of the jaws in oncological patients and the risk of MRONJ was higher in patients with metastases regardless of the type of anti-resorptive therapy. The use of Bisphosphonates and Denosumab was very common in the treatment of osteoporosis, up to 42.4% of the patients, and the incidence of MRONJ was higher than previously reported. It was possible to prevent the occurrence of MRONJ after oral surgery due to medical prophylaxis, non-traumatic surgical procedures, and photobiomodulation therapy (PBMT).

Italian Position Paper (SIPMO-SICMF) on Medication-Related Osteonecrosis of the Jaw (MRONJ)

“…The SIPMO-SICMF staging system of MRONJ has remained unchanged since its introduction in 2012 and it has been increasingly used in Italy for the last 10 years (Albanese et al, 2020;Antonelli et al, 2021;Bacci et al, 2021;Bettini et al, 2021;Di Fede et al, 2016;Franchi et al, 2021;Marcianò, Ieni, et al, 2021;Marcianò, Ingrasciotta, et al, 2021;Mauceri et al, 2018;Migliario et al, 2017;Pignatelli et al, 2021).…”