Background
Medication-related osteonecrosis of the jaw (MRONJ) is a serious adverse effect of antiresorptive drugs (such as bisphosphonates, denosumab) or antiangiogenic drugs. These therapies are primarily used to prevent pathological fractures of long bones associated with cancer or osteoporosis. MRONJ is characterized by a non-healing jawbone exposure, accompanied by persistent symptoms of inflammation. The necrosis complicates cancer therapy and significantly impacts the patients' quality of life.
The aim
Analysis and characteristics of the population of patients who developed MRONJ and were treated at the Department and Clinic over a 4-year period.
Material and method
This paper presents a retrospective clinical observation of 60 patients treated with MRONJ at the Department and Clinic of Cranio-Maxillofacial Surgery of the Silesian Medical University in Katowice between 2020 and 2024. After applying the study inclusion criteria, 41 patients were ultimately enrolled. The study considered the following patient parameters: gender, age, underlying disease, causative factors, type and route of antiresorptive drug administration. Particular attention was paid to the clinical symptoms in the oral cavity, location, stage and size of the necrotic lesions.
Results
The mean age of the patients in the study’s population was 68.3 (agemin=44, agemax=90), 73.2% (n=30) were taking antiresorptive medications due to cancer, and 26.8% (n=11) were taking antiresorptive medications due to osteoporosis. Gender was another key factor, as 73.2% (n=30) of patients were women. In the study group, the majority (85.4%, n=35) of patients were diagnosed with AAOMS stages II and III of MRONJ. Necrotic lesions were primarily located in the mandible (70.7%, n=29). Tooth extraction was identified as a causative factor in 61.0% of cases (n=25). Moreover, in 31.7% (n=13) of patients, denture was suspected as a factor of trauma to the dental arch, which was later diagnosed with necrosis.
Conclusions
Poor oral health, surgical procedures, and trauma from ill-fitting dentures can often be triggers for drug-induced osteonecrosis of the jaw.
