Antiresorptive agent-related osteonecrosis of the jaw (ARONJ) in urological malignancies: a multi-center retrospective study

Medication-related osteonecrosis of the jaw (MRONJ) is a severe side effect of antiresorptive medication. The aim of this study was to evaluate the incidence of denosumab-related osteonecrosis of the jaw and to compare the clinical and radiological extent of osteonecrosis. A retrospective study of patients who received Xgeva® at the Institut de Cancérologie de Lorraine (ICL) was performed. Patients for whom clinical and radiological (CBCT) data were available were divided into two groups: “exposed” for patients with bone exposure and “fistula” when only a fistula through which the bone could be probed was observed. The difference between clinical and radiological extent was assessed. The p-value was set at 0.05, and a total of 246 patients were included. The cumulative incidence of osteonecrosis was 0.9% at 6 months, 7% at 12 months, and 15% from 24 months. The clinical extent of MRONJ was significantly less than their radiological extent: in the “exposed” group, 17 areas (45%) were less extensive clinically than radiologically (p < 0.001) and respectively 6 (67%) for the “fistula” group (p < 0.031). It would seem that a CBCT is essential to know the real extent of MRONJ. Thus, it would seem interesting to systematically perform a CBCT during the diagnosis of MRONJ, exploring the entire affected dental arch.

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Denosumab-related osteonecrosis of the jaw after tooth extraction and the effects of a short drug holiday in cancer patients: a multicenter retrospective study

Osteoporosis International ◽

10.1007/s00198-021-05995-3 ◽

2021 ◽

Author(s):

T. Hasegawa ◽

◽

N. Ueda ◽

SI. Yamada ◽

S. Kato ◽

...

Keyword(s):

Retrospective Study ◽

Cancer Patients ◽

Tooth Extraction ◽

Osteonecrosis Of The Jaw ◽

Drug Holiday

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Characteristics of patients with osteonecrosis of the jaw with oral versus intravenous bisphosphonate treatment

Maxillofacial Plastic and Reconstructive Surgery ◽

10.1186/s40902-021-00310-w ◽

2021 ◽

Vol 43 (1) ◽

Author(s):

Seung-Hun Lee ◽

So-Young Choi ◽

Min-Su Bae ◽

Tae-Geon Kwon

Keyword(s):

Retrospective Study ◽

Clinical Characteristics ◽

Demographic Data ◽

Osteonecrosis Of The Jaw ◽

Group Differences ◽

Bisphosphonate Treatment ◽

Administration Route ◽

Lesion Number ◽

Different Characteristics ◽

Intravenous Bisphosphonate

Abstract Purpose This retrospective study was aimed to evaluate the clinical characteristics and treatment outcomes in patients with osteonecrosis of the jaw who were receiving oral versus intravenous (IV) bisphosphonate (BP). Materials and methods This retrospective study enrolled subjects who had been diagnosed with medication-related osteonecrosis of the jaw (MRONJ) during the period from July 2010 to June 2014. Information regarding the following demographic and clinical characteristics was collected: demographic data, administration route and type of BP, duration of BP medication, primary disease, number of involved sites, location of the lesion, number of surgeries, outcome of treatments, and laboratory test. All the patients were divided into oral and IV BP groups; and the between-group differences were compared. Results Total 278 patients were divided into two groups as per the route of BP administration. The proportion of oral BP-related MRONJ group were more dominant over IV BP group (oral BP, n = 251; IV BP, n = 27). In the IV BP group, the average dosing duration (31.4 months) was significantly shorter than that in the oral BP group (53.1 months) (P < 0.001). The average number of involved sites in the oral BP group (1.21 ± 0.48) was smaller than that in the IV BP group (1.63 ± 0.84) (P < 0.001). The average number of surgeries was higher in the IV BP group (1.65 ± 0.95) as compared to that in the oral BP group (0.98 ± 0.73) (P < 0.001). Outcome after the surgery for MRONJ after IV BP was poor than oral BP group. Conclusion IV administration of BP causes greater inhibition of bone remodeling and could lead more severe inflammation. Therefore, even if the duration of IV administration of BP is shorter than that of oral BP, the extent of the lesion could be more extensive. Therefore, the result suggests that the MRONJ after IV BP for cancer patients needs to be considered as different characteristics to oral BP group for osteoporosis patents.

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A Retrospective Study Evaluating Frequency and Risk Factors of Osteonecrosis of the Jaw in 576 Cancer Patients Receiving Intravenous Bisphosphonates

American Journal of Clinical Oncology ◽

10.1097/coc.0b013e3182155fcb ◽

2012 ◽

Vol 35 (4) ◽

pp. 386-392 ◽

Cited By ~ 53

Author(s):

Vivek Thumbigere-Math ◽

Lam Tu ◽

Sabrina Huckabay ◽

Arkadiusz Z. Dudek ◽

Scott Lunos ◽

...

Keyword(s):

Risk Factors ◽

Retrospective Study ◽

Cancer Patients ◽

Osteonecrosis Of The Jaw ◽

Intravenous Bisphosphonates

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CT Imaging Features of Antiresorptive agent-Related Osteonecrosis of the Jaw/ Medication-Related Osteonecrosis of the Jaws

Dentomaxillofacial Radiology ◽

10.1259/dmfr.20170323 ◽

2018 ◽

pp. 20170323 ◽

Cited By ~ 12

Author(s):

Akira Baba ◽

Tazuko K Goto ◽

Hiroya Ojiri ◽

Mutsumi Takagiwa ◽

Chiho Hiraga ◽

...

Keyword(s):

Osteonecrosis Of The Jaw ◽

Ct Imaging ◽

Imaging Features ◽

Osteonecrosis Of The Jaws ◽

Antiresorptive Agent

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A Clinical Retrospective Study of Surgical Treatment for Medication-Related Osteonecrosis of the Jaw

Journal of Hard Tissue Biology ◽

10.2485/jhtb.25.447 ◽

2016 ◽

Vol 25 (4) ◽

pp. 447-454 ◽

Cited By ~ 1

Author(s):

Shintaro Sukegawa ◽

Takahiro Kanno ◽

Hotaka Kawai ◽

Satoko Nakamura ◽

Akane Shibata ◽

...

Keyword(s):

Retrospective Study ◽

Surgical Treatment ◽

Osteonecrosis Of The Jaw

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Development of Antiresorptive Agent-Related Osteonecrosis of the Jaw After Dental Implant Removal: A Case Report

Journal of Oral Implantology ◽

10.1563/aaid-joi-d-18-00032 ◽

2018 ◽

Vol 44 (5) ◽

pp. 359-364

Author(s):

Shinsuke Yamamoto ◽

Keigo Maeda ◽

Izumi Kouchi ◽

Yuzo Hirai ◽

Naoki Taniike ◽

...

Keyword(s):

Dental Implants ◽

Dental Implant ◽

Osteonecrosis Of The Jaw ◽

Japanese Woman ◽

Implant Removal ◽

Antiresorptive Agent ◽

Oral Bisphosphonate ◽

Antiresorptive Agents ◽

The Right ◽

Implant Treatment

Dental implant treatment is a highly predictable therapy, but when potentially lethal symptoms or complications occur, dentists must remove the implant fixture. Recently, reports on antiresorptive agent-related osteonecrosis of the jaw have increased in the field of dental implants, although the relationship between dental implant treatment and antiresorptive agents remains unclear. Here, we report a case of antiresorptive agent-related osteonecrosis of the jaw that developed after dental implant removal. A 67-year-old Japanese woman with a medical history of osteoporosis and 7 years of oral bisphosphonate treatment was referred to our hospital with a chief complaint of painful right mandibular bone exposure. A family dentist removed the dental implants from the right mandible using a trephine drill without flap elevation in August 2016. However, the healing was impaired; she was referred to our hospital 3 months after the procedure. We performed a sequestrectomy of the mandible under general anesthesia. In conclusion, this patient's course has two important implications: First, the removal of dental implants from patients who are prescribed oral bisphosphonates for long durations can cause antiresorptive agent-related osteonecrosis of the jaw. Second, meticulous procedures are required to prevent and treat the development of antiresorptive agent-related osteonecrosis of the jaw after dental implant removal.

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Surgical Treatment of Medication-Related Osteonecrosis of the Jaw: A Retrospective Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17238801 ◽

2020 ◽

Vol 17 (23) ◽

pp. 8801

Author(s):

Na Rae Choi ◽

Jung Han Lee ◽

Jin Young Park ◽

Dae Seok Hwang

Keyword(s):

Retrospective Study ◽

Surgical Treatment ◽

Treatment Outcomes ◽

Maxillofacial Surgery ◽

Osteonecrosis Of The Jaw ◽

Oral And Maxillofacial Surgery ◽

Single Institution ◽

Patient Factors ◽

Surgical Success ◽

Negative Impacts

The purpose of this study was to confirm the success rate of surgical treatment of medication-related osteonecrosis of the jaw (MRONJ) in patients at a single institution (Association of Oral and Maxillofacial Surgery (AAOMS) stages 1, 2, or 3), and to identify the factors that influence treatment outcomes. As a result of analyzing the outcomes of treatment, surgical “success” was achieved in 93.97% (109) of cases, and “failure” was observed at 6.03% (7) cases. Analysis of patient factors that potentially affect treatment outcomes showed that zoledronate dose (p = 0.005) and the IV (intravenous) injection of drugs (p = 0.044) had significant negative impacts.

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