Retrospective analysis of 127 cases of medication related osteonecrosis of the jaw: a summary of 10 years' experience in a single center

doi:10.19438/j.cjoms.2022.01.014

Abstract

Abstract: PURPOSE: This study aimed to provide better diagnosis and treatment of medication related osteonecrosis of the jaw (MRONJ) by analyzing the clinical data retrospectively. METHODS: A total of 127 MRONJ cases surgically treated from January 2008 to June 2018 at Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine were enrolled. According to the diagnostic criteria and classification proposed by American Association of Oral and Maxillofacial Surgeons in 2014, the cause, risk factors and predilection site of MRONJ were analyzed and the treatment methods, therapeutic effects and prognosis were evaluated. RESULTS: Ninety-three cases(73.23%) occurred in mandible, thirty cases (23.62%) occurred in maxilla, four cases (3.15%) occurred in both maxilla and mandible. Trauma was the main cause of MRONJ, ninety-eight cases (77.17%) of MRONJ occurred due to trauma including tooth extraction, dental implantation and tooth exfoliation. Six cases (4.72%) were classified as stage 0,thirteen cases (10.24%) as stage Ⅰ, eighty cases (62.99%) as stage Ⅱ, twenty-eight cases (22.05%) as stage Ⅲ. In both stage 0 and stage Ⅰ, all the cases received conservative surgical methods including curettage of osteomyelitis, partial mandibulectomy and debridement. In stage Ⅱ, seventy-one cases received conservative surgical methods, eight cases received segmental mandibulectomy, one case received simultaneously free flap reconstruction after mandibulectomy. In stage Ⅲ, seventeen cases received conservative surgical methods, nine cases received segmental mandibulectomy, two cases received simultaneously free flap reconstruction after mandibulectomy. Three cases had relapse in both stage 0 and stage Ⅰ. Twenty-four cases had relapse in stage Ⅱ. Eleven cases relapsed in stage Ⅲ. CONCLUSIONS: MRONJ has a predilection to occur in mandible. Jaw trauma is the main cause. MRONJ is complicated and prone to relapse after partial resection.

Key words: Medication related osteonecrosis of the jaw, Bisphosphonate, Tooth extraction

CLC Number:

R782.3

HU Long-wei, YAN Ran, WEN Jin, ZHANG Chen-ping, ZHAO Xiao-mei, LI Si-yi. Retrospective analysis of 127 cases of medication related osteonecrosis of the jaw: a summary of 10 years' experience in a single center[J]. China Journal of Oral and Maxillofacial Surgery, 2022, 20(1): 72-76.

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