Clinical analysis of medication related osteonecrosis of the jaws: A growing severe complication in China

J Dent Sci. 2018 Sep;13(3):190-197. doi: 10.1016/j.jds.2017.12.003. Epub 2018 Feb 6.


Background/purpose: Medication-related osteonecrosis of the jaws (MRONJ) is an unusual but quite serious complication. However, its mechanism remains unclear, and its treatment protocol is still controversial.

Materials and methods: Our study involved 201 osteonecrosis of the jaw (ONJ) patients from September 2006 to March 2017. We analyzed risk factors, clinical characteristics, treatment, etc., by comparing MRONJ with other ONJs.

Results: Among 201 patients, MRONJ accounted for 14.71% and it presented a consistent increase tendency. In comparison with other ONJs, we considered advanced age, maxilla lesion, diabetes mellitus, tooth extraction, especially multi-teeth extraction as risk factors (P < 0.0125). Our study demonstrated that maxillary lesion was associated with an advanced stage and it was inclined to worse prognoses. We also found MRONJ had little correlation to Actinomyces infection. Surgical treatment could improve patients' condition successfully (P > 0.05). 81.3% patients with advanced stage showed complete or partial healing lesions after surgery.

Conclusion: Advanced age, maxilla lesion, diabetes mellitus, tooth extraction seem to be important triggering factors for MRONJ. Clinicians and surgeons should pay attention to maxillary lesions as it is related to severe symptoms and unfavorable prognosis. Once diagnosed as MRONJ, surgery is an effective treatment for patients with advanced stage.

Keywords: Bisphosphate; Osteonecrosis; Risk factor; Treatment.