A retrospective study on the incidence of medication-related osteonecrosis of the jaws (MRONJ) associated with different preventive dental care modalities

Support Care Cancer. 2022 Feb;30(2):1723-1729. doi: 10.1007/s00520-021-06587-x. Epub 2021 Sep 27.

Abstract

Purpose: To assess the efficacy of different preventive dental visits and treatments in reducing the risk of medication-related osteonecrosis of the jaws (MRONJ).

Methods: In this retrospective study, patients diagnosed with MRONJ were divided into 5 groups based on available data: no preventive dental visits (group 0); dental visits and compliance with recommended treatments, at the university hospital's dental clinic (group 1) or maxillofacial surgery unit (group 2), or at a private dentist's (group 3); dental visits at one of the above and noncompliance with proposed treatments (group 4); patients judged eligible by the oncologist on panoramic radiography (group 5). Patients were classified on severity of MRONJ according to the Italian SIPMO/SICMF 2.0 staging system. A descriptive analysis was performed on the results. Fisher's exact test was applied (p < 0.05).

Results: Ninety-three patients diagnosed with MRONJ were considered for the study, but 22 were excluded due to a lack of data, leaving a sample of 71 cases. MRONJ staging was only 0 for some patients (26.92%) in group 0. In all groups, the majority of patients had stage 2 MRONJ. The proportions of cases in stage 3 were 7.69% in group 0, 18.18% in group 3, and 43.48% in group 5. Groups 0 and 3 were somewhat similar as regard MRONJ staging. Most patients in group 5 had MRONJ stage 2 or 3. No statistically significant differences emerged between the groups.

Conclusions: Preventive dental care can reduce the risk of MRONJ providing patients comply with the specialist's recommendations.

Keywords: BRONJ Bisphosphonates; Cancer; MRONJ; Oral health; Prevention.

MeSH terms

  • Bisphosphonate-Associated Osteonecrosis of the Jaw* / epidemiology
  • Bisphosphonate-Associated Osteonecrosis of the Jaw* / prevention & control
  • Bone Density Conservation Agents*
  • Dental Care
  • Diphosphonates
  • Humans
  • Incidence
  • Jaw
  • Retrospective Studies

Substances

  • Bone Density Conservation Agents
  • Diphosphonates