Treatment outcomes and prognostic factors of medication-related osteonecrosis of the jaw: a case- and literature-based review

Objectives The purpose of this study was to investigate the treatment outcomes and prognostic factors of medication-related osteonecrosis of the jaw (MRONJ) in Japanese patients. Patients and methods Among 409 cases, treatment outcomes and prognostic factors were investigated in 275 patients. In sta...

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Bibliographic Details
Published in:Clinical oral investigations 2019-08, Vol.23 (8), p.3203-3211
Main Authors: Yamada, Shin-ichi, Kurita, Hiroshi, Kondo, Eiji, Suzuki, Shigeru, Nishimaki, Fumihiro, Yoshimura, Nobuhiko, Morioka, Masafumi, Ishii, Shutaro, Kamata, Takahiro
Format: Article
Language:English
Subjects:
Bisphosphonate-Associated Osteonecrosis of the Jaw - therapy
Bone Density Conservation Agents
Bone surgery
Clinical outcomes
Dentistry
Female
Humans
Jaw
Male
Medical prognosis
Medicine
Multivariate analysis
Original Article
Osteonecrosis
Patients
Prognosis
Quality of Life
Statistical analysis
Treatment Outcome
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Summary:Objectives The purpose of this study was to investigate the treatment outcomes and prognostic factors of medication-related osteonecrosis of the jaw (MRONJ) in Japanese patients. Patients and methods Among 409 cases, treatment outcomes and prognostic factors were investigated in 275 patients. In statistical analyses, the 1-year cumulative curative rate was calculated with the Kaplan-Meier method, and significance was examined with the Wilcoxon test. Cox’s proportional hazards regression analysis was used for the multivariate analysis. Results Resolution of the disease was achieved in 137 out of 275 MRONJ patients (49.8%). One-year cumulative curative rates were 39.8% in stage 1 patients, 26.3% in stage 2, and 19.0% in stage 3. The 1-year cumulative curative rates of treatment interventions were 17.2% for conservative treatment, 34.5% for sequestrectomy, and 40.7% for extended surgery including bone resection and segmental resection. As the prognostic factors of treatment outcomes, the type of medication, stage of MRONJ, and type of surgical intervention were identified as independent factors in a multivariate analysis. Conclusion These results suggest that surgical interventions may lead to a good prognosis in MRONJ patients. Clinical relevance This study indicated that surgical intervention for MRONJ might lead to improvement of prognosis and quality of life in MRONJ patients.
ISSN:1432-6981
1436-3771
DOI:10.1007/s00784-018-2743-0