SynthesisBMC oral health2026
Serum vitamin D Levels in patients with medication-related osteonecrosis of the jaw: a systematic review and meta-analysis.
Synthesis in BMC oral health, 2026. 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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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.
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Authors and funding
6 authors.
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Abstract
objectivesTo compare serum 25-hydroxyvitamin D [25(OH)D] levels between patients with medication-related osteonecrosis of the jaw (MRONJ) and antiresorptive-exposed controls. MATERIALS AND
methodsFollowing PRISMA guidelines, PubMed, Scopus, Web of Science, and Embase were searched through September 2025 for studies including adults (≥ 18 years) treated with bisphosphonates or denosumab that reported 25(OH)D levels in MRONJ cases and exposed controls. Random-effects models generated standardized mean differences (SMDs) with 95% confidence intervals (CIs). Heterogeneity, influence and subgroup analyses, random-effects meta-regression, and publication bias (Egger’s and Begg’s tests) were assessed.
resultsSix studies (five case–control, one cohort; 184 MRONJ, 175 controls) met inclusion criteria. Mean serum 25(OH)D was 33.16 ± 4.27 ng/mL in MRONJ patients and 36.86 ± 5.02 ng/mL in controls. The SMD was − 0.06 (95% CI, − 0.51 to 0.39; p = 0.79) with heterogeneity (I² = 75.0%; p < 0.001). After exclusion of two influential studies, heterogeneity decreased to 0% and the SMD remained non-significant (− 0.11; 95% CI, − 0.36 to 0.15; p = 0.41). Subgroup analyses by indication/population (mixed osteoporosis plus oncologic versus exclusively oncologic) showed no significant differences. Meta-regression indicated that control sample size and bisphosphonate exposure duration in MRONJ groups were associated with effect size. The certainty of evidence for the analyzed outcome was very low.
conclusionsPostdiagnosis serum 25(OH)D levels appear similar in MRONJ patients and antiresorptive-exposed controls; however, the evidence is limited and of very low certainty, so conclusions should be interpreted cautiously. CLINICAL RELEVANCE: In antiresorptive-treated adults, serum 25-hydroxyvitamin D levels measured after diagnosis do not differ meaningfully between patients with MRONJ and exposed controls, suggesting vitamin D is unlikely to be a primary determinant of MRONJ occurrence but may still modify disease course.
trial registrationCRD420251172147.
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