Radiological manifestations and clinical findings of patients with oncologic and osteoporotic medication-related osteonecrosis of the jaw

© 2024. The Author(s)..

Medication-related osteonecrosis of the jaw (MRONJ) poses a challenging form of osteomyelitis in patients undergoing antiresorptive therapies in contrast to conventional osteomyelitis. This study aimed to compare the clinical and radiological features of MRONJ between patients receiving low-dose medications for osteoporosis and those receiving high-dose medications for oncologic purposes. The clinical, panoramic radiographic, and computed tomography data of 159 patients with MRONJ (osteoporotic group, n = 120; oncologic group, n = 39) who developed the condition after using antiresorptive medications for the management of osteoporosis or bone malignancy were analyzed. The osteoporotic group was older (75.8 vs. 60.4 years, p < 0.01) and had a longer duration of medication usage than the oncologic group (58.1 vs. 28.0 months, p < 0.01). Pus discharge and swelling were more common in the osteoporotic group (p < 0.05), whereas bone exposure was more frequent in the oncologic group (p < 0.01). The mandibular cortical index (MCI) in panoramic radiographs was higher in the osteoporotic group (p < 0.01). The mean sequestra size was larger in the oncologic group than in the osteoporotic group (15.3 vs. 10.6 mm, p < 0.05). The cured rate was significantly higher in the osteoporotic group (66.3% vs. 33.3%, p < 0.01). Oncologic MRONJ exhibited distinct clinical findings including rapid disease onset, fewer purulent signs, and lower cure rates than osteoporotic MRONJ. Radiological features such as sequestrum size on CT scan, and MCI values on panoramic radiographs, may aid in differentiating MRONJ in osteoporotic and oncologic patients.

Medienart:

E-Artikel

Erscheinungsjahr:

2024

Erschienen:

2024

Enthalten in:

Zur Gesamtaufnahme - volume:14

Enthalten in:

Scientific reports - 14(2024), 1 vom: 16. Apr., Seite 8744

Sprache:

Englisch

Beteiligte Personen:

Shin, Jeong Won [VerfasserIn]
Kim, Jo-Eun [VerfasserIn]
Huh, Kyung-Hoe [VerfasserIn]
Yi, Won-Jin [VerfasserIn]
Heo, Min-Suk [VerfasserIn]
Lee, Sam-Sun [VerfasserIn]
Choi, Soon-Chul [VerfasserIn]

Links:

Volltext

Themen:

Bone Density Conservation Agents
Clinical assessment
Diphosphonates
Journal Article
Malignancy
Medication-related osteonecrosis of the jaw (MRONJ)
Osteoporosis
Radiographic assessment

Anmerkungen:

Date Completed 18.04.2024

Date Revised 19.04.2024

published: Electronic

Citation Status MEDLINE

doi:

10.1038/s41598-024-59500-x

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM371166225