Do Healing Rates Differ Between Medication-Related and Medication-Unrelated Osteonecrosis of the Jaw?
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| Název: | Do Healing Rates Differ Between Medication-Related and Medication-Unrelated Osteonecrosis of the Jaw? |
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| Autoři: | Fujimori M; Chief Director, Department of Oral and Maxillofacial Surgery, Kushiro Rosai Hospital, Kushiro, Japan. Electronic address: m-fujimori@mail.goo.ne.jp., Toriyabe Y; Chief Director, Department of Oral and Maxillofacial Surgery, Kaiseikai Onishi Hospital, Asahikawa, Japan., Sakakibara N; Vice Director, Department of Oral and Maxillofacial Surgery, Nikko Memorial Hospital, Muroran, Japan., Nojima M; Associate Professor, Center for Translational Research, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan., Makino S; Chief Director, Department of Oral Surgery, Hokuto Hospital, Obihiro, Japan. |
| Korporace: | Hokkaido Association of Hospital Dentistry Medication-Related Osteonecrosis of the Jaw Research Group |
| Zdroj: | Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons [J Oral Maxillofac Surg] 2025 Sep; Vol. 83 (9), pp. 1143-1156. Date of Electronic Publication: 2025 Jun 06. |
| Způsob vydávání: | Journal Article; Multicenter Study; Comparative Study |
| Jazyk: | English |
| Informace o časopise: | Publisher: W.B. Saunders Co Country of Publication: United States NLM ID: 8206428 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1531-5053 (Electronic) Linking ISSN: 02782391 NLM ISO Abbreviation: J Oral Maxillofac Surg Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: [Philadelphia, PA : W.B. Saunders Co., c1982- |
| Výrazy ze slovníku MeSH: | Wound Healing*/physiology , Bisphosphonate-Associated Osteonecrosis of the Jaw*/surgery , Bisphosphonate-Associated Osteonecrosis of the Jaw*/therapy , Osteonecrosis*/chemically induced , Jaw Diseases*/chemically induced , Jaw Diseases*/surgery , Jaw Diseases*/therapy, Humans ; Male ; Female ; Prospective Studies ; Aged ; Middle Aged ; Aged, 80 and over ; Treatment Outcome ; Bone Density Conservation Agents/adverse effects |
| Abstrakt: | Background: The healing rates, time to complete healing, effectiveness of operative therapy, and factors associated with healing for medication-related osteonecrosis of the jaw (MRONJ) and medication-unrelated osteonecrosis of the jaw (MUONJ) remain unclear. Purpose: The study aimed to estimate and compare the healing rates between patients with MRONJ and MUONJ and identify prognostic factors associated with healing. Study Design, Setting, Sample: A 25-center prospective cohort study was performed-the investigators enrolled patients with ONJ treated using a standardized therapeutic protocol between 2013 and 2016. Patients with a history of radiation therapy to the jaws were excluded. Predictor Variable: The primary predictor variable was the ONJ diagnosis. The secondary predictors involved a set of heterogenous variables grouped into demographic, medical, clinical condition, and perioperative categories. Main Outcome Variables: The primary outcome variable was treatment duration, defined as the time (in months) between therapy initiation and site healing, date of the final visit, or loss to follow-up. Covariates: Not applicable. Analyses: Descriptive statistics and cumulative healing rates were calculated. P < .05 was considered significant. Results: The sample comprised 332 subjects with a mean age of 72.3 ± 11.1 years, among whom 116 (34.9%) were male. The MUONJ and MRONJ groups included 41 (12.3%) and 291 (87.7%) subjects, respectively, exhibiting 1-year cumulative healing rates of 92.1 and 47.3% (P < .01), respectively. The hazard ratio for complete healing was 3.7 (95% CI = 2.5 to 5.3, P < .01) in subjects with MUONJ compared with those with MRONJ. The median time to complete healing was 6 (3.8 to 8.2) months in the MUONJ group, while less than half of the subjects in the MRONJ group healed within 12 months. The 1-year cumulative healing rate was 92.1 and 47.3% (P < .01) in the operative therapy and nonoperative therapy groups, respectively. Conclusions and Relevance: MUONJ was associated with better healing rates and a shorter time to healing compared with MRONJ. Operative therapy also showed potential benefits. Decisions for treating ONJ should be based on these findings alongside individual patient needs and conditions. (Copyright © 2025 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.) |
| Contributed Indexing: | Investigator: K Shimazaki; M Miyasawa; H Miyate; H Kitada; Y Satoh; T Yamashita; Y Nakajima; Y Hariya; I Kobayashi; S Nishikata; Y Taishi; C Sugiura; K Kasahara; Y Asaka; M Okada; N Shibayama; H Suetsugu; T Suzuki; T Abe; A Tanimura; N Kaku; A Kudou; M Donen; Y Kawaguchi |
| Substance Nomenclature: | 0 (Bone Density Conservation Agents) |
| Entry Date(s): | Date Created: 20250623 Date Completed: 20250903 Latest Revision: 20250905 |
| Update Code: | 20250905 |
| DOI: | 10.1016/j.joms.2025.05.023 |
| PMID: | 40550482 |
| Databáze: | MEDLINE |
Nájsť tento článok vo Web of Science | Abstrakt: | Background: The healing rates, time to complete healing, effectiveness of operative therapy, and factors associated with healing for medication-related osteonecrosis of the jaw (MRONJ) and medication-unrelated osteonecrosis of the jaw (MUONJ) remain unclear.<br />Purpose: The study aimed to estimate and compare the healing rates between patients with MRONJ and MUONJ and identify prognostic factors associated with healing.<br />Study Design, Setting, Sample: A 25-center prospective cohort study was performed-the investigators enrolled patients with ONJ treated using a standardized therapeutic protocol between 2013 and 2016. Patients with a history of radiation therapy to the jaws were excluded.<br />Predictor Variable: The primary predictor variable was the ONJ diagnosis. The secondary predictors involved a set of heterogenous variables grouped into demographic, medical, clinical condition, and perioperative categories.<br />Main Outcome Variables: The primary outcome variable was treatment duration, defined as the time (in months) between therapy initiation and site healing, date of the final visit, or loss to follow-up.<br />Covariates: Not applicable.<br />Analyses: Descriptive statistics and cumulative healing rates were calculated. P < .05 was considered significant.<br />Results: The sample comprised 332 subjects with a mean age of 72.3 ± 11.1 years, among whom 116 (34.9%) were male. The MUONJ and MRONJ groups included 41 (12.3%) and 291 (87.7%) subjects, respectively, exhibiting 1-year cumulative healing rates of 92.1 and 47.3% (P < .01), respectively. The hazard ratio for complete healing was 3.7 (95% CI = 2.5 to 5.3, P < .01) in subjects with MUONJ compared with those with MRONJ. The median time to complete healing was 6 (3.8 to 8.2) months in the MUONJ group, while less than half of the subjects in the MRONJ group healed within 12 months. The 1-year cumulative healing rate was 92.1 and 47.3% (P < .01) in the operative therapy and nonoperative therapy groups, respectively.<br />Conclusions and Relevance: MUONJ was associated with better healing rates and a shorter time to healing compared with MRONJ. Operative therapy also showed potential benefits. Decisions for treating ONJ should be based on these findings alongside individual patient needs and conditions.<br /> (Copyright © 2025 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.) |
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| ISSN: | 1531-5053 |
| DOI: | 10.1016/j.joms.2025.05.023 |