Oral-Health-Related Quality of Life After Surgical Treatment of Osteonecrosis of the Jaws

Oteri, Giacomo; Ponte, Francesco Saverio De; Runci, Michele; Peditto, Matteo; Marcianó, Antonia; Cicciù, Marco

doi:10.1097/scs.0000000000004087

Cited by 29 publications

(23 citation statements)

References 34 publications

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“…As reported by Oteri et al 12 the management of ONJ patients includes not only the general treatment of MRONJ in terms of pain relief and prevention of the development of new areas of necrosis, but also the preservation of patients' quality of life (QoL). Therefore, in these patients the resolution of acute infection and pain provides a support to the management of MRONJ, leading to a significant improvement of perceived QoL.…”

Section: Discussionmentioning

confidence: 99%

Surgical Management of Medication-Related Osteonecrosis of the Jaw Patients Related to Dental Implants

Nisi

Izzetti

Gennai

et al. 2020

Journal of Craniofacial Surgery

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The aim of the present study is to report a case series of patients with peri-implant medication-related osteonecrosis of the jaw (MRONJ), in particular describing the onset of the condition and surgical treatment outcome. Material and Methods: Fifteen consecutive patients with clinical diagnosis of peri-implant MRONJ were retrospectively included in the study. The sample was stratified on the base of oral, pharmacological, and general health variables. The number of affected implants was recorded in all patients, and MRONJ staging applied. Surgical treatment was performed with a standardized operative protocol, involving implant removal, sequestrectomy, debridement of soft tissue, and bone curettage. Follow-up evaluating surgical outcome was performed at twelve months after surgery. Results: in our study sample, patients were almost equally distributed in terms of underlying diseases in osteoporotic and oncologic patients. All MRONJ lesions were symptomatic, and in 6 patients bone exposure was detected. 40 implants in total were evaluated, with MRONJ being present around 29 implants. 12 patients were diagnosed with Stage III MRONJ, and 3 patients with Stage II MRONJ. Surgical treatment leads to complete healing in 86.7% of cases, with 100% success for maxillary MRONJ. Conclusions: Surgical treatment seems to have a positive impact on MRONJ treatment also in cases of peri-implant involvement. However, monitoring and prevention are fundamental in patients under pharmacological treatment with anti-resorptive/ antiangiogenic drugs, as peri-implant MRONJ can develop also in absence of specific traumatic events.

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Section: Discussionmentioning

confidence: 99%

Surgical Management of Medication-Related Osteonecrosis of the Jaw Patients Related to Dental Implants

Nisi

Izzetti

Gennai

et al. 2020

Journal of Craniofacial Surgery

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“…Stage III was not observed. The treatment of MRONJ aims to reduce the painful symptoms, control infection, and reestablish social contact with family and friends, thus improving the physical and mental state and consequently improving the QOL of these individuals ( 11 , 22 ).…”

Section: Discussionmentioning

confidence: 99%

“…According to the SF-12 questionnaire that evaluates the general QOL ( 2 ), MRONJ is a condition that can lead to worsening of the physical and mental state of patients. Treatment for MRONJ aims to restore the QOL by resolving the symptoms in the jaws ( 11 ).…”

Section: Introductionmentioning

confidence: 99%

The impact of medication-related osteonecrosis of the jaws on the quality of life in cancer patients

Caminha¹,

Alcantara²,

Carvalho³

et al. 2020

J Clin Exp Dent

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Background To evaluate the impact of oral health on the quality of life (QOL) of individuals undergoing cancer treatment at the time of diagnosis of medication-related osteonecrosis of the jaw (MRONJ). Material and Methods The present cross-sectional study analyzed patients with MRONJ from 2013 to 2019. The collected data included demographic data, base disease, medications associated with MRONJ, route of administration and time of use, signs, symptoms, and tomographic features of acute MRONJ, staging according to American Association of Oral and maxillofacial Surgeons position paper 2014 (AAOMS), type of dental treatment performed, outcome, and the responses to the Oral Health Impact Profile questionnaire (OHIP-14). Statistical analysis was performed using the Tukey test to study the association between oral condition and the QOL. A p-value of less than 0.05 was considered statistically significant. Results The sample consisted of 16 medical records of patients with MRONJ. Psychological discomfort showed alarmingly significant results ( p < 0.001) with strong negative impact on the QOL of the patients. Functional limitation was the least affected dimension ( p = 0.747). The other dimensions did not show statistically significant results. Conclusions MRONJ compromises oral health and negatively impacts the QOL, especially with respect to the psychological discomfort (worry and stress). The OHIP-14 questionnaire proved to be an effective tool in the assessment of this impact. Key words: Medication-related osteonecrosis of the jaw, quality of life, oral health, OHIP-14.

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“…Dental disease has a significant impact on quality of life, ranging from pain and functional limitation to psychosocial sequelae, thus it is essential to prevent it where possible. 5,6,28 It is possible that this complication could have been avoided if there was a formalized office follow-up protocol to ensure they did not neglect removal of their hardware. Specifically, a more thorough assessment of this patient's social situation and insurance status may have promoted timely follow up.…”

Section: Discussionmentioning

confidence: 99%

“…4 The significant long-term impact on quality of life associated with dental pathology has been clearly documented, underlining the need for preventative measures. 5,6 Case Report A 30-year-old male with a history of right-sided body/parasymphyseal and left-sided angle fractures sustained secondary to a physical altercation at age 16, presented with left sided dental pain and a desire to remove his original arch bars from the time of injury management.…”

Section: Introductionmentioning

confidence: 99%

Clinical and Radiological Analysis of Arch Bars Over-Retained for 14 years Post Maxillo-Mandibular Fixation

Brooker

Bruce

Chen

et al. 2021

FACE

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Maxillo-mandibular fixation (MMF) is common technique used in mandibular fractures to stabilize the fragments and maintain the patient in normal dental occlusion during the healing process. Arch bars with elastics are one of the most frequently used methods of MMF and are temporary, and designed to be removed after the healing process is completed. There is controversy as to what impact the hardware has on dental hygiene and oral health. No reports of long-term retention of the hardware exist. This report details the case of arch bars retained for 14 years. The patient underwent MMF and internal fixation at age 16 for a complex mandibular fracture and failed to follow-up for timely removal of the arch bars due to loss of insurance. He presented at age 30 with dental pain and returned to the treating center for removal. He was in normal occlusion, but general indices of dental and periodontal health were extremely poor with multiple non-restorable teeth despite reporting good oral hygiene in the intervening period. A decline in overall dental health was evident at 1 year following removal of arch bars. Due to the presence of smooth surface dental caries, it was concluded that the presence of the arch-bars had exacerbated already poor oral hygiene and contributed to the extensive dental pathology seen. This case highlights the need for timely follow-up and hardware removal. Understanding each patient’s individual social and financial circumstances is essential to this process and a formalized office recall process may have prevented this complication.

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Oral-Health-Related Quality of Life After Surgical Treatment of Osteonecrosis of the Jaws

Cited by 29 publications

References 34 publications

Surgical Management of Medication-Related Osteonecrosis of the Jaw Patients Related to Dental Implants

Surgical Management of Medication-Related Osteonecrosis of the Jaw Patients Related to Dental Implants

The impact of medication-related osteonecrosis of the jaws on the quality of life in cancer patients

Clinical and Radiological Analysis of Arch Bars Over-Retained for 14 years Post Maxillo-Mandibular Fixation

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