Changing face of medication-related osteonecrosis of the jaw: Sheba Medical Center experience-fifteen years

J Bone Miner Metab. 2020 Nov;38(6):819-825. doi: 10.1007/s00774-020-01113-1. Epub 2020 Jun 7.

Abstract

Introduction: Our aim is to track the development of the epidemiological characteristics in patient populations diagnosed with MRONJ at the Sheba Medical Center.

Materials and methods: The files of patients diagnosed with MRONJ from 2003 until December 2017 were retrieved. Data on demographics, medical background, type and duration of drug use and triggering events at presentation was collected.

Results: The study included 448 patients, 336 females and 112 males. A decrease in the proportion of multiple myeloma patients (p < 0.05) and an increase in the proportion of patients with bone metastases of solid tumors has been observed recently. An increase in the proportion of cases in osteoporosis patients compared with oncology patients is evident (p < 0.01). Overtime a higher proportion of patients presented at an earlier stage of MRONJ (p < 0.01).

Conclusions: As a result of changes in treatment protocols and increased awareness of oncology caregivers, including referral and consultation with Oral Medicine specialists, there has been a change in the demographics and presentation of the disease.

Keywords: Bone modifying agents; Jaws; MRONJ; Osteonecrosis.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Bisphosphonate-Associated Osteonecrosis of the Jaw / diagnosis
  • Bisphosphonate-Associated Osteonecrosis of the Jaw / pathology*
  • Bisphosphonate-Associated Osteonecrosis of the Jaw / therapy
  • Bone Density Conservation Agents / therapeutic use
  • Comorbidity
  • Diphosphonates / therapeutic use
  • Drug Prescriptions
  • Female
  • Humans
  • Male
  • Middle Aged
  • Osteoporosis / drug therapy
  • Risk Factors

Substances

  • Bone Density Conservation Agents
  • Diphosphonates