Treatment outcomes and time to healing of medication-related osteonecrosis of the jaw based on image findings. 2023

Takazumi Yasui, and Hiroki Nagamine, and Kenta Tanaka, and Moemi Kimura, and Takeshi Karube, and Hiromasa Kawana, and Katsuhiro Onizawa
Department of Dentistry and Oral Surgery, Kawasaki Municipal Kawasaki Hospital, Kawasaki, Japan.

This study aimed to evaluate the prognostic treatment outcome of non-operative management of medication-related osteonecrosis of the jaw (MRONJ), particularly regarding the relationship between image findings and treatment outcomes. This single-center, retrospective observational study included patients with MRONJ who were conservatively treated between 2010 and 2020. All patients were evaluated in terms of MRONJ treatment outcomes, time to healing, and prognostic factors, including sex, age, underlying disease, antiresorptive drug type, discontinuation of antiresorptive treatment, chemotherapy, corticosteroid treatment, diabetes mellitus, location of MRONJ, clinical stage of MRONJ, and computed tomography image findings. The complete healing rate among the patients was 68.5%. Cox proportional hazards regression analysis revealed that "Sequestrum formation" on the internal texture (hazard ratio = 3.66; 95% confidence interval, 1.30-10.29; P =.014) and chemotherapy (hazard ratio = 0.41; 95% confidence interval, 0.18-0.95; P =.037) were significantly associated with treatment outcome. The median time to healing in patients with "Sequestrum formation" on the internal texture (4.4 months) was significantly shorter than the median time to healing in those marked with "Sclerosis" or "Normal" (35.5 months; P <.001) and "Lytic changes with sclerosis" (14.5 months; P =.015). The image findings on the internal texture of the lesions at the initial examination and chemotherapy were associated with the treatment outcomes of nonoperative management of MRONJ. The image findings of "Sequestrum formation" were associated with lesions taking a short time to heal and better outcomes, whereas "Sclerosis" and "Normal" were associated with lesions with longer healing times.

UI MeSH Term Description Entries
D011379 Prognosis A prediction of the probable outcome of a disease based on a individual's condition and the usual course of the disease as seen in similar situations. Prognostic Factor,Prognostic Factors,Factor, Prognostic,Factors, Prognostic,Prognoses
D004164 Diphosphonates Organic compounds which contain P-C-P bonds, where P stands for phosphonates or phosphonic acids. These compounds affect calcium metabolism. They inhibit ectopic calcification and slow down bone resorption and bone turnover. Technetium complexes of diphosphonates have been used successfully as bone scanning agents. Bisphosphonate,Bisphosphonates
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D012189 Retrospective Studies Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons. Retrospective Study,Studies, Retrospective,Study, Retrospective
D016896 Treatment Outcome Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series. Rehabilitation Outcome,Treatment Effectiveness,Clinical Effectiveness,Clinical Efficacy,Patient-Relevant Outcome,Treatment Efficacy,Effectiveness, Clinical,Effectiveness, Treatment,Efficacy, Clinical,Efficacy, Treatment,Outcome, Patient-Relevant,Outcome, Rehabilitation,Outcome, Treatment,Outcomes, Patient-Relevant,Patient Relevant Outcome,Patient-Relevant Outcomes
D050071 Bone Density Conservation Agents Agents that inhibit BONE RESORPTION and/or favor BONE MINERALIZATION and BONE REGENERATION. They are used to heal BONE FRACTURES and to treat METABOLIC BONE DISEASES such as OSTEOPOROSIS. Antiresorptive Agent,Antiresorptive Agents,Antiresorptive Drugs,Bone Resorption Inhibitors,Bone Resorption Inhibitory Agents,Agent, Antiresorptive,Inhibitors, Bone Resorption,Resorption Inhibitors, Bone
D059266 Bisphosphonate-Associated Osteonecrosis of the Jaw Necrotic jaws or other maxillofacial skeleton necrosis associated with bisphosphonate use (see BISPHOSPHONATES). Injury, dental procedures, and trauma can trigger the necrotic process. Bisphosphonate Osteonecrosis,Bisphosphonate-Associated Osteonecrosis,Bisphosphonate-Associated Osteonecrosis of the Jaws,Bisphosphonate-Induced Osteonecrosis of the Jaw,Bisphosphonate-Induced Osteonecrosis of the Jaws,Bisphosphonate-Related Osteonecrosis of the Jaw,Osteonecrosis of the Jaw, Bisphosphonate-Associated,Osteonecrosis of the Jaw, Bisphosphonate-Induced,Osteonecrosis of the Jaw, Bisphosphonate-Related,Osteonecrosis of the Jaws, Bisphosphonate-Associated,Osteonecrosis of the Jaws, Bisphosphonate-Induced,Osteonecrosis of the Jaws, Bisphosphonate-Related,Bisphosphonate Associated Osteonecrosis,Bisphosphonate Associated Osteonecrosis of the Jaw,Bisphosphonate Associated Osteonecrosis of the Jaws,Bisphosphonate Induced Osteonecrosis of the Jaw,Bisphosphonate Induced Osteonecrosis of the Jaws,Bisphosphonate Osteonecroses,Bisphosphonate Related Osteonecrosis of the Jaw,Bisphosphonate-Associated Osteonecroses,Osteonecroses, Bisphosphonate,Osteonecroses, Bisphosphonate-Associated,Osteonecrosis of the Jaw, Bisphosphonate Associated,Osteonecrosis of the Jaw, Bisphosphonate Induced,Osteonecrosis of the Jaw, Bisphosphonate Related,Osteonecrosis of the Jaws, Bisphosphonate Associated,Osteonecrosis of the Jaws, Bisphosphonate Induced,Osteonecrosis of the Jaws, Bisphosphonate Related,Osteonecrosis, Bisphosphonate,Osteonecrosis, Bisphosphonate-Associated

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