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J Bone Miner Res. 2017 Oct;32(10):2022-2029. doi: 10.1002/jbmr.3191. Epub 2017 Jul 11.

Evaluation of the Treatment Strategies for Medication-Related Osteonecrosis of the Jaws (MRONJ) and the Factors Affecting Treatment Outcome: A Multicenter Retrospective Study with Propensity Score Matching Analysis.

Author information

1
Department of Oral and Maxillofacial Surgery, Wakayama Medical University, Wakayama, Japan.
2
Department of Clinical Oral Oncology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
3
Perioperative Oral Management Center, Nagasaki University Hospital, Nagasaki, Japan.
4
Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
5
Department of Dentistry and Oral Surgery, Kansai Medical University, Osaka, Japan.
6
Department of Oral and Maxillofacial Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
7
Department of Oral and Maxillofacial Surgery, Nara Medical University, Kashihara, Japan.
8
Department of Dentistry and Oral Surgery, Osaka City University Graduate School of Medicine, Osaka City, Japan.
9
Department of Oral and Maxillofacial Surgery, Juntendo University Faculty of Medicine, Tokyo, Japan.

Abstract

Medication-related osteonecrosis of the jaw (MRONJ) is an adverse event that may inhibit the treatment of primary disease and remarkably influence the patient's quality of life. The treatment methods for MRONJ, nonsurgical and surgical, are controversial, with no agreement as to which method provides the best outcome and should therefore be recommended. This multicenter retrospective study aimed to investigate the treatment methods and outcome in a large number of patients with MRONJ in Japan, utilizing propensity score matching analysis. A total of 361 patients with MRONJ, at eight hospitals, were registered in this study retrospectively. Various demographic and treatment-related variables were examined and analyzed to determine their correlation with the treatment outcome. After propensity score matching for treatment methods (nonsurgical versus surgical treatment), 176 patients were analyzed by logistic regression. It was shown that those with low-dose administration of an antiresorptive agent and surgical treatment had better outcomes. Furthermore, in 159 patients who underwent surgical treatment, those who underwent extensive surgery experienced significantly better treatment outcomes than those who underwent conservative surgery. This is the first study to compare treatment methods for MRONJ using propensity score matching analysis. The results indicated that extensive surgical treatment should be performed as first-choice therapy for patients with MRONJ.

KEYWORDS:

CLINICAL TRIALS; DENTAL BIOLOGY; MEDICATION-RELATED OSTEONECROSIS OF THE JAWS (MRONJ); OSTEOPOROSIS; TUMOR-INDUCED BONE DISEASE

PMID:
28585700
DOI:
10.1002/jbmr.3191
[Indexed for MEDLINE]
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