Association between elevated plasma glucose levels and medication-related osteonecrosis of the jaw

Abstract

Objectives: Medication-related osteonecrosis of the jaw (MRONJ) is a type of jawbone necrosis caused by the use of drugs for some types of cancer and osteoporosis. Previous research has shown that normoglycemia plays an important rolein the development and treatment of oral lesions. The current study aimed to evaluate the associationsbetween chronic vascular disease, inflammation, and immune deficiency during dysglycemia and the developmentof MRONJ. Materials and Methods: Our research group investigated data collected between January 1, 2019, and December 31, 2020. In total, 260 patients at the Inpatient Care Unit, Department of Oromaxillofacial Surgery and Stomatology, Semmelweis University were selected. Results: There was a significant association between hyperglycemia and MRONJ. Vascular anomaly and immune dysfunction caused byhyperglycemia can leadto the development of necrosis after tooth extraction. The risk of jawbone necrosis can be reduced by premedication. Conclusions: Ischemia is a complication of abnormal glucose level, which is a possible risk factor of MRONJ development. Hence, uncontrolled or poorly regulated plasma glucose levels can significantly increase the risk of jawbone necrosis. Clinical relevance: Uncontrolled or poorly regulated plasma glucose levels significantly increasesthe risk of jawbone necrosis after invasive dental or oral surgical interventions. The number of patients with dysglycemia and anti-resorptive therapy is increasing. Therefore, patients with these conditions will be provided with medical care in dental offices more frequently.