J Korean Assoc Oral Maxillofac Surg 2018; 44(5): 225~231
Clinical characteristics and recurrence-related factors of medication-related osteonecrosis of the jaw
Mong-Hun Kang, Dong-Keon Lee, Chang-Woo Kim, In-Seok Song, Sang-Ho Jun
Department of Oral and Maxillofacial Surgery, Korea University Anam Hospital, Seoul, Korea
In-Seok Song
Department of Oral and Maxillofacial Surgery, Korea University Anam Hospital, 73 Inchon-ro, Seongbuk-gu, Seoul 02841, Korea
TEL: +82-2-920-5423 FAX: +82-2-921-7348
E-mail: sis80@naver.com
ORCID: https://orcid.org/0000-0002-0763-8838
Sang-Ho Jun
Department of Oral and Maxillofacial Surgery, Korea University Anam Hospital, 73 Inchon-ro, Seongbuk-gu, Seoul 02841, Korea
TEL: +82-2-920-5423 FAX: +82-2-921-7348
E-mail: junsang@korea.ac.kr
ORCID: https://orcid.org/0000-0002-4243-788X
Received July 10, 2018; Revised August 14, 2018; Accepted September 4, 2018.; Published online October 31, 2018.
© Korean Association of Oral and Maxillofacial Surgeons. All rights reserved.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
 Abstract
Objectives: The purpose of this study was to investigate the demographic and clinical characteristics of patients with medication-related osteonecrosis of the jaw (MRONJ) and to elucidate factors affecting recurrence in surgical treatment.
Materials and Methods: A total of 51 patients who were diagnosed with MRONJ were analyzed according to demographic and clinical features and treatment results through a retrospective chart review from 2013 to 2017 in the Department of Oral and Maxillofacial Surgery, Korea University Anam Hospital, Seoul in Korea.
Results: Alendronate composed the majority of medication doses (55.6%), followed by ibandronate (20.0%), risedronate (15.6%), and zoledronate (6.7%). Forty patients (88.9%) were given oral medication, and five patients (11.1%) were intravenously treated, and the mean duration of medication use was 61.1±42.9 months. A total of 10 patients (22.2%) had a drug holiday before MRONJ-induced dental treatment lasting an average of 6.8±7.0 months. MRONJ occurred 2.7 times more in the mandible, with 41 cases (73.2%) occurring in the mandible and 15 cases (26.8%) occurring in the maxilla, and the prevalence of affected posterior parts (premolar-molar) was six times greater than that of the anterior parts (incisor-canine) (48 cases vs 8 cases, 85.7% vs 14.3%). The most common dental cause of MRONJ was tooth extraction (69.6%). Regarding recurrence, there was no statistical difference in recurrence rate according to either site or stage. However, recurrence occurred in 4 out of 34 cases (11.8%) in the primary closure group and 9 out of 20 cases (45.0%) in the secondary healing group, and there was a statistical difference with respect to closure technique.
Conclusion: The identified risk factors in patients taking bone resorption inhibitors can aid dental clinicians in ensuring prevention and proper treatment of MRONJ.
Keywords: Bisphophonate-associated osteonecrosis of the jaw, Operative surgical procedure, Recurrence


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31 October 2018
Vol. 44
No. 5 pp. 205~247

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