Radiographic bone loss and the risk of medication‐related osteonecrosis of the jaw (MRONJ) in multiple myeloma patients—A retrospective case control study

Abstract

Risk factors for medication-related osteonecrosis of the jaws (MRONJ) include type and duration of antiresorptive drugs, dental trauma, local anatomy, systemic underlying conditions and therapy, smoking, and the presence of periodontal disease. However, there is a lack of studies elucidating the role of periodontal disease as risk predictor. In the present study, the dental charts of 100 multiple myeloma (MM) patients and 16 MM patients who developed MRONJ were studied. Information about age, gender, smoking history, diabetes, steroid drug intake, type and duration of bisphosphonate (BP) treatments, MRONJ status, missing teeth, periapical lesions, widening of the periodontal ligament, and periodontal status was collected. The periodontal status was determined as a percentage of missing bone at the mesial and distal surfaces of each tooth. Multivariable logistic regression was performed to identify risk factors associated with MRONJ. In the selected model, using the COX analysis, categorical bone loss percentage is significantly associated with MRONJ (P = 0.009), with hazard ratio 0.042 (high vs low) and 95% CI 0.004 to 0.453. Gender, steroid, Aredia BP type, and periapical are also significant in selected model. In conclusion, advanced alveolar bone loss and missing teeth were strongly related to the occurrence of MRONJ in MM patients.

Incidence and Risk Factors of Osteonecrosis of Femoral Head in Multiple Myeloma Patients Undergoing Dexamethasone-Based Regimens

“…Previous studies showed that 10-33% patients had symptoms of affected joints and monthly bisphosphonate prophylaxis may contribute to the low rate of symptoms [10,12]. Notably, bisphosphonate, as a protective factor for hip, may increase risks for developing osteonecrosis of the jaw according to recent studies [13][14][15]. In addition, other drugs such as thalidomide and bortezomib were not found to be significantly related to BioMed Research International the occurrence of osteonecrosis.…”

Association between periodontitis and medication‐related osteonecrosis of the jaw: A systematic review and meta‐analysis

“…In this line, Fleisher et al reported on a cohort of 26 patients receiving BPs with CTX levels <150 pg/mL who underwent surgical management for BRONJ, or simply at‐risk patients who went through surgical interventions and who all exhibited a 100% positive response rate without relapse or complications. They emphasized the fact that this method lacks specificity as a prognosis or predictive measure, opposed to a clinical periodontal parameter (periodontal ligament widening) which truly showed effectivity in this issues, a discovery which was later confirmed by Wazzan et al…”

İlaca Bağli Çene Kemi̇ği̇ Osteonekrozu: Bi̇r Derleme

“…13 Bu risk faktörlerini ilaçla ilgili faktörler (dozu, tipi, tedavi süresi), lokal faktörler (dentoalveolar cerrahi, periodontal hastalıklar, önceden var olan enflamatuar durumlar, protez kullanımı), sistemik ve demografik faktörler (yaş, ırk) ve genetik faktörler olarak ele alabiliriz. 5,42,43 Periodontal hastalık veya periapikal patoloji gibi önceden var olan enflamatuar hastalıklar iyi bilinen bir risk faktörüdür. 9 Saad ve arkadaşlarının yaptığı bir çalışmada kanser hastalarında önceden var olan enflamatuar diş hastalığı, vakaların % 50'sinde risk faktörü olarak gösterilmiştir.…”