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Evaluation of the Treatment Strategies for Medication‐Related Osteonecrosis of the Jaws (MRONJ) and the Factors Affecting Treatment Outcome: A Multicenter Retrospective Study with Propensity Score Matching Analysis
Author(s) -
Hayashida Saki,
Soutome Sakiko,
Yanamoto Souichi,
Fujita Shigeyuki,
Hasegawa Takumi,
Komori Takahide,
Kojima Yuka,
Miyamoto Hironori,
Shibuya Yasuyuki,
Ueda Nobuhiro,
Kirita Tadaaki,
Nakahara Hirokazu,
Shinohara Mitsuyo,
Umeda Masahiro
Publication year - 2017
Publication title -
journal of bone and mineral research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.882
H-Index - 241
eISSN - 1523-4681
pISSN - 0884-0431
DOI - 10.1002/jbmr.3191
Subject(s) - medicine , propensity score matching , retrospective cohort study , logistic regression , osteonecrosis of the jaw , adverse effect , surgery , osteoporosis , bisphosphonate
Medication‐related osteonecrosis of the jaw (MRONJ) is an adverse event that may inhibit the treatment of primary disease and remarkably influence the patient's quality of life. The treatment methods for MRONJ, nonsurgical and surgical, are controversial, with no agreement as to which method provides the best outcome and should therefore be recommended. This multicenter retrospective study aimed to investigate the treatment methods and outcome in a large number of patients with MRONJ in Japan, utilizing propensity score matching analysis. A total of 361 patients with MRONJ, at eight hospitals, were registered in this study retrospectively. Various demographic and treatment‐related variables were examined and analyzed to determine their correlation with the treatment outcome. After propensity score matching for treatment methods (nonsurgical versus surgical treatment), 176 patients were analyzed by logistic regression. It was shown that those with low‐dose administration of an antiresorptive agent and surgical treatment had better outcomes. Furthermore, in 159 patients who underwent surgical treatment, those who underwent extensive surgery experienced significantly better treatment outcomes than those who underwent conservative surgery. This is the first study to compare treatment methods for MRONJ using propensity score matching analysis. The results indicated that extensive surgical treatment should be performed as first‐choice therapy for patients with MRONJ. © 2017 American Society for Bone and Mineral Research.