Maxillofac Plast Reconstr Surg.  2023;45(1):12. 10.1186/s40902-023-00377-7.

Associated systemic diseases and etiologies of medication‑related osteonecrosis of the jaw: a retrospective study of 265 surgical cases

• Chang H
• Kim M
• Ahn K

• KMID: 2552541
• DOI: http://doi.org/10.1186/s40902-023-00377-7

Abstract

Background
Medication-related osteonecrosis of the jaw (MRONJ) is one of the complications caused by vari‑ ous drugs. As there are increasing reports of MRONJ, it is important to diagnose and identify patients who have the potential risk of the disease. The aim of this study was to analyze the systemic diseases, etiology, and treatment results of MRONJ. Material and methods A total of 265 MRONJ operations were reviewed retrospectively. This study included patients who were diagnosed as MRONJ and those who also received surgery, ranging from simple extraction to reconstruc‑ tion with free flaps, from 2009 to 2021. Each patient’s systemic disease and eitology and basic demographic informa‑ tion was taken into consideration.
Results
The most common diseases related were osteoporosis (n = 127), breast cancer (n = 77), multiple myeloma (n = 27), prostate cancer (n = 26), and etc. (n = 12). The related causes of MRONJ were extraction (n = 138), implants (n = 40), and irritations by prosthesis (n = 29); however, 55 cases were occurred spontaneously. Out of 265 patients, 214 were women while 51 were men. The average age when the surgery took place was 67.7 and 69.8 years for male and female patients, respectively. Saucerization and sequestrectomy (n = 252) was the most common surgical treat‑ ment, followed by mandibulectomy (n = 12) and partial maxillectomy (n = 1). While 4 cases occurred in both jaws, 168 cases were in the mandible and 93 cases were in the maxilla.
Conclusion
Nearly 50 % of the MRONJ patients had osteoporosis and the other patients who received bone target‑ ing agents parentral had bone metastasis of various cancers. Extraction is the most common related event for MRONJ.

Keyword

Osteonecrosis of the jaw; Osteoporosis; Metastatic cancer, Bisphosphonate; Denosumab; Bone targeting agents