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A critical assessment of the medication-related osteonecrosis of the jaw classification in stage I patients: a retrospective analysis

Journal of the Korean Association of Oral and Maxillofacial Surgeons / Journal of the Korean Association of Oral and Maxillofacial Surgeons, (P)2234-7550; (E)2234-5930
2021, v.47 no.2, pp.99-111
https://doi.org/10.5125/jkaoms.2021.47.2.99
Oliver Ristow (Department of Oral and Maxillofacial Surgery, University Hospital Heidelberg, Germany)
Lena Hürtgen (Department of Oral and Maxillofacial Surgery, University of Heidelberg, Heidelberg, Germany)
Julius Moratin (Department of Oral and Maxillofacial Surgery, University Hospital Heidelberg, Germany)
Maximilian Smielowski (Department of Oral and Maxillofacial Surgery, University of Heidelberg, Heidelberg, Germany)
Christian Freudlsperger (Department of Oral and Maxillofacial Surgery, University Hospital Heidelberg, Germany)
Michael Engel (Department of Oral and Maxillofacial Surgery, University Hospital Heidelberg, Germany)
Jürgen Hoffmann (Department of Oral and Maxillofacial Surgery, University Hospital Heidelberg, Germany)
Thomas Rückschloß (Department of Oral and Maxillofacial Surgery, University of Heidelberg, Heidelberg, Germany)

Abstract

Objectives: It is unclear whether the extent of intraoral mucosa defects in patients with medication-related osteonecrosis of the jaw indicates disease severity. Therefore, this study investigated whether mucosal lesions correlate with the true extent of osseous defects in stage I patients. Materials and Methods: Retrospectively, all patients with stage I medication-related osteonecrosis of the jaw who underwent surgical treatment between April 2018 and April 2019 were enrolled. Preoperatively, the extent of their mucosal lesions was measured in clinical evaluations, and patients were assigned to either the visible or the probeable bone group. Intraoperatively, the extent of necrosis was measured manually and with fluorescence. Results: Fifty-five patients (36 female, 19 male) with 86 lesions (46 visible bone, 40 probeable bone) were enrolled. Intraoperatively, the necrotic lesions were significantly larger (P<0.001) than the preoperative mucosal lesions in both groups. A significant (P<0.05) but very weak (R2<0.2) relationship was noted between the extent of the mucosal lesions and the necrotic bone area. Conclusion: Preoperative mucosal defects (visible or probeable) in patients with medication-related osteonecrosis of the jaw do not indicate the extent of bone necrosis or disease severity.

keywords
Medication-related osteonecrosis of the jaw, Bisphosphonate-related osteonecrosis of the jaw, Antiresorptiva-related osteonecrosis of the jaw, Definition, Classification

Journal of the Korean Association of Oral and Maxillofacial Surgeons