ArticleJournal of oral biology and craniofacial research
Medication-related osteonecrosis of the jaw in Northern Thailand: A one-year cohort study of risk factors, incidence, and healing outcomes.
Article in Journal of oral biology and craniofacial research. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Medication-related osteonecrosis of the jaw (MRONJ) is a serious complication of antiresorptive and antiangiogenic therapies. Identifying its incidence and risk factors is vital for prevention and management. Objective: To identify clinical and pharmacological factors associated with healing outcomes in patients with MRONJ who receiving antiresorptive or antiangiogenic therapy treated at a single center over one-year analysis period. Additionally, we examined the healing outcome and its association with MRONJ stage and anatomical location. Methods: This single-center cohort study, combining retrospective baseline data collection with prospective longitudinal follow-up over one year in Northern Thailand. Patient demographics, medication history, clinical features, and treatment outcomes were analyzed. Results: Seventy-four patients (79.73 % female; mean age 72.07 ± 10.78 years) with 205 sites were analyzed. The overall MRONJ prevalence was 22.44 %, highest among patients with bone metastasis (85.71 %) and multiple myeloma (23.53 %). One-year incidence reached 23.46 %, with cancer patients showing the highest incidence (100 %). Tooth extraction was the leading local risk factor (71.74 %). Overall healing rate was 67.39 %, with better outcomes in stage 1 (77.78 %) and stage 2 (68.00 %) compared to stage 3 (0 %). In stages 1 and 2, univariable analysis showed stage 1 had higher odds of healing (OR: 1.84; 95 % CI: 0.53-6.41), and multivariable analysis confirmed this trend (adjusted OR: 3.51; 95 % CI: 0.16-76.4), though neither was statistically significant. Conclusion: MRONJ prevalence and incidence remain substantial in high-risk populations. Better healing was observed in early-stage lesions, emphasizing the importance of early detection and timely intervention to improve clinical outcomes.
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