J Korean Assoc Oral Maxillofac Surg 2019; 45(2): 108~115
Risk factors of medication-related osteonecrosis of the jaw: a retrospective study in a Turkish subpopulation
Onur Șahin1, Onur Odabașı2, Toghrul Aliyev1, Birkan Tatar1
1Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, ?zmir Katip ?elebi University, ?zmir, 2Department of Oral and Maxillofacial Surgery, Ankara Yıldırım Beyazıt University, Ankara, Turkey
Onur Șahin
Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, ?zmir Katip ?elebi University, Aydınlıkevler Mahallesi, Cemil Meri? Bulvarı, 6780 Sokak, #48, ?zmir 35640, Turkey, TEL: +90-(232)-325-25-35 FAX: +90-5054410192, E-mail: onursahin43@hotmail.com
ORCID: https://orcid.org/0000-0001-7816-1443
Received July 2, 2018; Revised July 30, 2018; Accepted July 31, 2018.; Published online April 30, 2019.
© The 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.
Objectives: Medication-related osteonecrosis of the jaw (MRONJ) is a well-known side effect of certain drugs that are used to influence bone metabolism to treat osteometabolic disease or cancers. The purpose of our study was to investigate how high-concentration and low-concentration bisphosphonate (BP) intake affects the disease severity.
Materials and Methods: Data collected from the medical records of 52 patients treated with BPs, antiresorptive, antiangiogenic drugs and diagnosed with MRONJ were included in this study. Age, sex, type of systemic disease, type of drug, duration of drug treatment, jaw area with MRONJ, drug administration protocol, and MRONJ clinical and radiological findings were obtained. Patients were divided into two groups: anti-neoplastic (Group I, n=23) and anti-osteoporotic (Group II, n=29). Statistical evaluations were performed using the IBM SPSS ver. 21.0 program.
Results: In both groups, more females had MRONJ. MRONJ was found in the mandibles of 30 patients (Group I, n=14; Group II, n=16). When we classified patients according to the American Association of Oral and Maxillofacial Surgeons staging system, significant differences were seen between groups (χ2=12.23, P<0.01). More patients with advanced stage (stage 2-3) MRONJ were found in Group I (60.9%).
Conclusion: According to our results, high-concentration BP intake, age and duration of drug intake increased disease severity.
Keywords: Bisphosphonate-associated osteonecrosis of the jaw, Osteonecrosis, Risk factors, Zoledronic acid

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30 April 2019
Vol. 45
No. 2 pp. 49~120

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