Factors Exacerbating Clinical Symptoms and CT Findings in Patients with Medication-Related Osteonecrosis of the Jaw Receiving Conservative Therapy: A Multicenter Retrospective Study of 53 Cases

Yuka Kojima, Sakiko Soutome, Mitsunobu Otsuru, Saki Hayashida, Yuki Sakamoto, Shunsuke Sawada and Masahiro Umeda
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Yuka Kojima: Department of Dentistry and Oral Surgery, Kansai Medical University, Hirakata 573-1191, Japan
Sakiko Soutome: Department of Oral Health, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki 852-8588, Japan
Mitsunobu Otsuru: Department of Clinical Oral Oncology, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki 852-8588, Japan
Saki Hayashida: Department of Clinical Oral Oncology, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki 852-8588, Japan
Yuki Sakamoto: Department of Dentistry and Oral Surgery, Kansai Medical University Medical Center, Moriguchi 570-8507, Japan
Shunsuke Sawada: Department of Dentistry and Oral Surgery, Kansai Medical University, Hirakata 573-1191, Japan
Masahiro Umeda: Department of Clinical Oral Oncology, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki 852-8588, Japan

IJERPH, 2022, vol. 19, issue 13, 1-12

Abstract: Recent reports have shown that better treatment outcomes are obtained with surgical therapy in patients with medication-related osteonecrosis of the jaw (MRONJ) than with conservative therapy. However, conservative treatment is selected due to factors such as old age and poor general condition. Conservative therapy aims to relieve symptoms and prevent lesion exacerbation; however, the lesion may expand rapidly in some cases. This study investigated the clinical and imaging findings of 53 MRONJ patients undergoing conservative therapy, and the changes in the clinical findings and the lesion enlargement on CT imaging were examined. Improved clinical findings and no worsening of the imaging findings were considered overall comprehensive treatment successes. Among the 53 patients, the clinical symptoms disappeared or improved in 15 patients, whereas they worsened in 6. In contrast, osteolytic lesion enlargement occurred in 17 patients. The comprehensive treatment outcome of conservative therapy was successful in 12 patients and unsuccessful in 41 patients. The periosteal reaction was significantly correlated with poor comprehensive treatment outcomes ( p = 0.038). MRONJ lesions may advance, even if they appear to improve clinically while undergoing conservative treatments. Patients, especially those with periosteal reactions, must be closely followed up with CT examinations, regardless of the clinical findings.

Keywords: medication-related osteonecrosis of the jaw; conservative treatment; periosteal reaction; exacerbation; treatment outcome (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
References: View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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