Vitamin D (25-OHD) deficiency may increase the prevalence of medication-related osteonecrosis of the jaw

J Craniomaxillofac Surg. 2017 Dec;45(12):2068-2074. doi: 10.1016/j.jcms.2017.09.015. Epub 2017 Sep 23.

Abstract

Introduction: Osteonecrosis of the jaw (ONJ) is a severe complication of antiresorptive medication (AM) in the treatment of bone-affecting cancer-related conditions and osteoporosis. Aim of this study was to reveal whether patients treated with AM and show Medication Related OsteoNecrosis of the Jaw (MRONJ) are vitamin D deficient or not.

Materials and methods: A 2 year retrospective study evaluated hospital records of 63 patients who received AM. Patients were divided into two groups. One group (n = 45) consisted of patients who presented a stage 2 ONJ (eb+ = exposed bone). Second group patients (n = 18) (eb- = no exposed bone) presented for extraction of teeth. Serum levels of vitamin D (25-OHD) were analysed. P values ≤ 0.05 in t-test were regarded as statistically significant.

Results: Serum levels of 25-OHD were significantly higher in the eb(-) group (29.5 ng/ml), than in the eb(+) group (20.49 ng/ml). Blood levels of calcium were also significantly higher in eb(-) group (2.25 mmol/L; 0.11 SD) than in eb(+) group (2.175 mmol/L; 0.16 SD).

Conclusion: Prevalence of MRONJ in AM treated patients seems to be increased by low serum 25-OHD. A measurable tendency in the role of 25-OHD for the development of MRONJ was recorded and leads to the recommendation for a sufficient vitamin D substitution in patients treated with AM.

Keywords: 25-OHD; BRONJ; MRONJ; Osteonecrosis; Vitamin D.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Bone Density Conservation Agents / adverse effects*
  • Female
  • Humans
  • Jaw Diseases / chemically induced*
  • Jaw Diseases / epidemiology*
  • Jaw Diseases / etiology
  • Male
  • Middle Aged
  • Osteonecrosis / chemically induced*
  • Osteonecrosis / epidemiology*
  • Osteonecrosis / etiology
  • Prevalence
  • Retrospective Studies
  • Vitamin D / analogs & derivatives*
  • Vitamin D Deficiency / complications*

Substances

  • Bone Density Conservation Agents
  • Vitamin D
  • 25-hydroxyvitamin D