Oral Health-Related Quality of Life and Mental Health Impairment in Patients Affected by Medication-Related Osteonecrosis of the Jaws: A Case–Control Pilot Study

Abstract

In the present case–control study, the impact of medication-related osteonecrosis of the jaws (MRONJ) on patients’ oral health-related quality of life (OHRQoL), overall quality of life (QoL), and psychological status was evaluated using a set of questionnaires. These questionnaires included the Oral Health Impact Profile-14 (OHIP-14), the Short Form 36 Health Survey Questionnaire (SF-36), and the hospital anxiety and depression scale (HADS). A total of 25 MRONJ patients and 25 controls were included in the study. The results showed that MRONJ patients had a significantly poorer OHRQoL (OHIP-14 score p-value: 0.003) and lower general QoL, particularly in the domains of “physical functioning”, “physical role”, “body pain”, “general health”, and “vitality” in the SF-36 questionnaire (p-values: 0.001, 0.001, 0.013, 0.001, and 0.020). Although there were no significant differences between the groups in the SF-36 domains of “social functioning”, “emotional role”, and “mental health”, the mean sub-scores of the HADS, specifically the depression and anxiety scores (HADS-D and HADS-A), were significantly higher in MRONJ patients (p-values: 0.002 and 0.009). However, the “mental health” domain of the SF-36 questionnaire showed a correlation with both HADS-A and HADS-D scores (p-values: 0.003 and 0.031). Therefore, a comprehensive clinical examination of MRONJ patients should include the assessment of OHRQoL, overall QoL, and psychological profile using different questionnaires. This approach aims to gather detailed information about patients’ physical and psychological well-being, enabling the development of tailored treatments.

Oral Hygiene, Dental Status, and Quality of Life in cancer patients with Medication related osteonecrosis of the jaws- A cross sectional study: Part 2.

“…In the present study, we found that MRONJ was predominantly seen in older individuals (aged ≥ 60 years), with a higher prevalence among females and predominantly affected the mandible aligning with the ndings of Caminha et al 14 The propensity for mandibular involvement is often attributed to its limited end-arterial blood supply and a higher ratio of cortical to cancellous bone. 9 Our ndings revealed that 23.3% of patients presented with stage 1 MRONJ, while 46% had stage 2 MRONJ, consistent with the ndings of Calabria et al, 22 which also showed a higher prevalence of stages 1 and 2 MRONJ.…”

Improvement of Quality of Life after Surgical Treatment of Patients with MRONJ: A Prospective Analysis Using the SF-12 and OHIP-14 Questionnaires

“…Subsequent case–control studies are warranted to compare individuals with identical underlying conditions, both with and without MRONJ, in order to elucidate this association. Moreover, standardization of questionnaires for better comparability would be appropriate [ 30 ]. Likewise, the utilization of specific Patient Reported Outcome Measures (PROMs) questionnaires with established psychometric properties would enhance validity, as generic QOL measures may not sufficiently capture mood disturbances [ 16 ].…”

Medication-Related Osteonecrosis of the Jaw: A Case Report of an Unusual Side Effect of Adalimumab

“…Some studies have shown that localized periodontal or dental disease may precede the onset of MRONJ [23]. Dentists, as part of a multidisciplinary team, have a critical role in preventing MRONJ because the development of this condition can be reduced through prophylactic dental care and the maintenance of good oral hygiene [24][25][26][27]. The importance of prevention is also critical in patients who have to take adalimumab, as this study poses the need to further investigate the association between it and the adverse reaction of MRONJ.…”