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<p>Medication-related osteonecrosis of the jaw (MRONJ) is a rare but severe complication of antiresorptive therapy with bisphosphonates or denosumab in osteoporotic patients. MRONJ can adversely affect both quality of life and the treatment of osteoporosis. The aim of this study was to evaluate the efficacy of early surgical treatment of MRONJ lesions and to assess the possible influence of variables such as advanced age, advanced stage of MRONJ, and concomitant treatment of rheumatoid arthritis on treatment outcomes. We performed a retrospective evaluation of osteoporotic patients treated for stage I-III MRONJ at a single institution between January 2016 and December 2022. All patients underwent early surgical treatment according to a standardized therapeutic protocol and were followed up for at least 6&#xa0;months after surgical treatment. Eighty-eight patients, mostly women (95.5%), were surgically treated for 93 MRONJ stage I (9.8%), II (73.1%), and III (17.2%) lesions. Thirteen patients (14.8%) were concurrently treated for rheumatoid arthritis. Early surgical treatment resulted in complete cure of MRONJ lesions with a single surgical procedure in 86 of 88 patients (97.7%) and 91 of 93 MRONJ lesions (97.8%). Age over 75&#xa0;years, advanced-stage MRONJ and concomitant treatment for rheumatoid arthritis were not negatively associated with surgical treatment outcomes in this study. Early surgical treatment according to the described treatment protocol is highly effective in achieving complete healing of MRONJ lesions in osteoporotic patients regardless of disease stage and can be used as a first-line treatment in patients with osteoporosis who have no contraindications and consent to surgical treatment.</p>

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Early Surgical Therapy for Managing Medication-Related Osteonecrosis of the Jaw in Patients with Osteoporosis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年10月30日

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  • K. Mikušková,
  • D. Hvizdoš,
  • D. Statelová,
  • J. Payer,
  • T. Siebert

摘要

Medication-related osteonecrosis of the jaw (MRONJ) is a rare but severe complication of antiresorptive therapy with bisphosphonates or denosumab in osteoporotic patients. MRONJ can adversely affect both quality of life and the treatment of osteoporosis. The aim of this study was to evaluate the efficacy of early surgical treatment of MRONJ lesions and to assess the possible influence of variables such as advanced age, advanced stage of MRONJ, and concomitant treatment of rheumatoid arthritis on treatment outcomes. We performed a retrospective evaluation of osteoporotic patients treated for stage I-III MRONJ at a single institution between January 2016 and December 2022. All patients underwent early surgical treatment according to a standardized therapeutic protocol and were followed up for at least 6 months after surgical treatment. Eighty-eight patients, mostly women (95.5%), were surgically treated for 93 MRONJ stage I (9.8%), II (73.1%), and III (17.2%) lesions. Thirteen patients (14.8%) were concurrently treated for rheumatoid arthritis. Early surgical treatment resulted in complete cure of MRONJ lesions with a single surgical procedure in 86 of 88 patients (97.7%) and 91 of 93 MRONJ lesions (97.8%). Age over 75 years, advanced-stage MRONJ and concomitant treatment for rheumatoid arthritis were not negatively associated with surgical treatment outcomes in this study. Early surgical treatment according to the described treatment protocol is highly effective in achieving complete healing of MRONJ lesions in osteoporotic patients regardless of disease stage and can be used as a first-line treatment in patients with osteoporosis who have no contraindications and consent to surgical treatment.