Medication-related osteonecrosis of the lower jaw without osteolysis on computed tomography images.
J Bone Miner Metab
; 42(1): 27-36, 2024 Jan.
Article
en En
| MEDLINE
| ID: mdl-38194089
ABSTRACT
INTRODUCTION:
Surgery is the standard treatment for medication-related osteonecrosis of the jaw (MRONJ). This study reviewed patients with mandibular MRONJ who underwent surgical treatment, and in particular the characteristics of non-osteolytic MRONJ with no evidence of osteolysis on CT were described. MATERIALS ANDMETHODS:
We conducted a retrospective study of patients with mandibular MRONJ who underwent surgery between January 2016 and September 2022. Various clinical and imaging factors regarding treatment outcomes were investigated and analyzed. Additionally, the disease course of non-osteolytic MRONJ was examined in detail.RESULTS:
This study included 55 patients (66 surgeries) with a mean age of 74.7. The primary disease was osteoporosis (24 patients) and malignancy (31 patients); the type of antiresorptive agent was bisphosphonate (BP) in 21 patients and denosumab (DMB) in 26. BP was initially administered; however, it was changed to DMB in eight patients. Preoperatively, the cumulative cure rates for all 66 surgeries were 72.8% at 1 year and 77.3% at 2 years. Cure rates were significantly lower in patients with malignancy, those without osteolysis, and those who underwent sequestrum removal or marginal mandibulectomy than those with osteoporosis, osteolysis, and segmental mandibulectomy. Non-osteolytic MRONJ was observed in eight patients, all with malignancy and receiving high-dose DMB. Only two patients were cured after the initial surgery, and most patients ultimately underwent segmental mandibulectomy.CONCLUSIONS:
Surgical treatment yielded good treatment outcomes in most patients with mandibular MRONJ; however, the cure rate was lower in patients with malignancy who showed no osteolysis on CT images.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Osteólisis
/
Osteoporosis
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Conservadores de la Densidad Ósea
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Osteonecrosis de los Maxilares Asociada a Difosfonatos
/
Neoplasias
Tipo de estudio:
Observational_studies
/
Risk_factors_studies
Límite:
Aged
/
Humans
Idioma:
En
Revista:
J Bone Miner Metab
Asunto de la revista:
METABOLISMO
Año:
2024
Tipo del documento:
Article
País de afiliación:
Japón