Prognostic factors of the medication-related osteonecrosis of the jaw

Abstract

Introduction: The potential risk factors of the medication-related osteonecrosis of the jaw remain the subject of research because of the different results of the studies. Aim: In our study, we examined the potential prognostic factors of the medication-related osteonecrosis of the jaw. Method: Patients with medication-related osteonecrosis of the jaw presenting between June 2006 and November 2013 were included in this study. Prognosis was examined, based on stage improvement, healing and the rate of relapse. The minimum follow-up time was 5 years. Statistical analysis: The results were evaluated by Fisher’s exact test, Mann–Whitney test, Kruskal–Wallis probe and chi-square test. The outcomes were accepted as significant when the p value was <0.05. Results: The stage stated at the first check-up indicated poor prognosis (p = 0.009). The relapse rate of patients with non-insulin-dependent diabetes mellitus was significantly higher than the relapse rate of those without diabetes mellitus (p = 0.050). Regarding the relapse rate, the relationship between patients receiving anti-estrogen therapy and those without hormonal therapy was significant (p = 0.036). The prognosis of mandibular necrosis was significantly worse (p = 0.003) than the prognosis of maxillary necrosis. We did not find significant connection between prognosis and gender, age, administration route of bisphosphonate, invasive procedures preceding the necrosis, chemotherapeutic and steroid treatment. Conclusion: Of the factors studied here, the stage stated at the first check-up, the localization of the necrotic bone parts, diabetes mellitus and anti-estrogen therapy used simultaneously with the antiresorptive therapy affected the prognosis of the medication-related osteonecrosis of the jaw.