ArticleSupportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer2025
Introducing equivalent and threshold doses in the assessment of medication-related osteonecrosis of the jaw risk: insights from a descriptive study in Iran.
Article in Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors.
Funding
Abstract
purposeTo investigate the clinical characteristics and risk factors associated with medication-related osteonecrosis of the jaw (MRONJ) and to introduce two metrics-equivalent dose (ED) and threshold dose (TD)-as predictive risk assessment tools.
methodsIn this cross-sectional study, 193 patient records were reviewed from Shahab Dental Clinic and the Oral Medicine Department of Mashhad Dental School (2017-2023). Patients were categorized according to MRONJ stage (0-3) or as "at-risk." Demographic data, comorbidities, clinical manifestations, and detailed medication profiles were collected. ED for each medication was standardized to the cumulative dose of four years of weekly oral alendronate use (4 × 52 × 70 mg = 14,560 mg). TD was defined as one unit of this ED and served as a cumulative risk cut-off. Statistical analyses included T-tests, ANOVA, and Chi-square tests.
resultsMRONJ was identified in 40.4% of cases, while 59.6% were classified as at-risk. Advanced stages were significantly associated with higher ED, prolonged medication use, and key risk factors, including oncologic diseases, medication type and route of administration, comorbidities, age, and surgical interventions such as extractions and ill-fitting dentures (P < 0.001). The novel metrics demonstrated strong predictive value. ED values were significantly higher in zoledronic acid users compared to denosumab users (2.40 [1.05, 6.00] vs. 1.23 [0.75, 2.37], P < 0.001), and positively correlated with MRONJ severity (R = 0.46, P < 0.001). The odds ratio for MRONJ associated with ED was 1.17 (95% CI: 1.06-1.30).
conclusionThis study offers critical insights into MRONJ risk stratification, highlighting the cumulative impact of medication dose alongside clinical risk factors. The introduction of ED and TD represents a transformative advancement in MRONJ risk prediction, enabling precise prevention strategies and guiding clinical management toward standardized care protocols.
Indexed as
Identifiers
40619534What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.