Clinical and Radiological Features of Medication-Related Osteonecrosis of the Jaws: Comparison of Staging Systems

Abstract

Medication-related osteonecrosis of the jaw (MRONJ) has been recognized as one of the most disabling comorbidities associated to the assumption of bisphosphonates (BPs) and antiresorptive drugs. To date, several classifications identify the stages of this pathology to propose different protocols for a better management way. This pilot retrospective study aims to compare two of the most used MRONJ classifications (AAOMS vs SIPMO-SICMF), analyzing CT scans and clinical features of patients with documented MRONJ. For each patient, clinical features and radiological findings were analyzed before any therapeutic procedure. The diagnostic differences between the AAOMS and SIPMO-SICMF classification were recorded and analyzed according to the treatment outcomes. These findings highlight different approaches for the patient’s treatment related to the MRONJ stages. Our results suggest a continuous update of the international guidelines to uniform the treatment for the improvement of the patients’ quality of life.

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).…”