Surgical treatment of stage 2 medication-related osteonecrosis of the jaw compared to osteomyelitis

Cranio. 2018 Nov;36(6):373-380. doi: 10.1080/08869634.2017.1365413. Epub 2017 Aug 30.

Abstract

Objective: To compare the characteristics and outcomes of patients who underwent surgical treatment for stage 2 medication-related osteonecrosis of the jaw (MRONJ) versus osteomyelitis.

Methods: This retrospective study compared the following variables in 73 patients with stage 2 MRONJ versus 89 patients with osteomyelitis: impaired wound healing after surgery, sex, age, the presence of actinomycosis, location of the jaw lesion, and involvement of the inferior alveolar nerve (IAN).

Results: There were significant differences between the groups in age, sex, rates of impaired wound healing, actinomycosis, and the location (anterior/posterior) of the lesion. Impaired wound healing after surgical treatment in the stage 2 MRONJ group was associated with patient age. All patients with impaired wound healing after the initial surgery recovered fully after reoperation.

Conclusions: These findings for surgical treatment of stage 2 MRONJ may help clinicians plan surgical treatment of MRONJ.

Keywords: MRONJ; bisphosphonate; osteomyelitis; osteonecrosis; surgical procedure.

MeSH terms

  • Actinomycosis
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Bisphosphonate-Associated Osteonecrosis of the Jaw / physiopathology
  • Bisphosphonate-Associated Osteonecrosis of the Jaw / surgery*
  • Female
  • Humans
  • Male
  • Mandibular Nerve
  • Middle Aged
  • Osteomyelitis / physiopathology
  • Osteomyelitis / surgery*
  • Reoperation
  • Retrospective Studies
  • Severity of Illness Index
  • Treatment Outcome
  • Wound Healing