Is medication-related osteonecrosis of the jaw around dental implants associated with the implant design and prosthesis characteristics?

IF 5.5 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of dentistry Pub Date : 2025-09-24 DOI:10.1016/j.jdent.2025.106133

Jaeyeon Kim , Jun-Young Kim , Eun-Jeong Choi , Hyeon-Gyu Jo , Hyung Jun Kim , Wonse Park

{"title":"Is medication-related osteonecrosis of the jaw around dental implants associated with the implant design and prosthesis characteristics?","authors":"Jaeyeon Kim , Jun-Young Kim , Eun-Jeong Choi , Hyeon-Gyu Jo , Hyung Jun Kim , Wonse Park","doi":"10.1016/j.jdent.2025.106133","DOIUrl":null,"url":null,"abstract":"<div><h3>Purpose</h3><div>This study aimed to identify risk factors associated with medication-related osteonecrosis of the jaw (MRONJ) around dental implants, focusing on implant/prosthesis characteristics and peri-implantitis.</div></div><div><h3>Methods</h3><div>This retrospective study included 355 dental implants obtained from 67 patients, each with at least one implant affected by MRONJ, who visited Yonsei University Dental Hospital between January 2008 and March 2022. The outcome variable was the presence or absence of MRONJ. Predictor variables included implant location, crestal module design, prosthesis type, emergence profile, emergence angle (EA), and peri-implantitis. A generalized estimating equation model was used to adjust for within-patient clustering effects.</div></div><div><h3>Results</h3><div>A total of 355 implants were analyzed, of which 112 implants were affected by MRONJ and 243 were not affected. External-type implants had higher odds of MRONJ than tissue-level implants (OR, 4.07; 95 % CI, 1.23–13.45). The odds of MRONJ were higher in implants with peri-implantitis compared to those without peri-implantitis (OR, 7.43; 95 % CI, 2.74–20.14). In tissue-level implants, MRONJ was significantly associated with a convex profile (39.1 %) than in those with straight or concave profiles (15.8 %). In bone-level implants, MRONJ was significantly higher in prostheses with an EA of >30º on at least one side, compared to those with EA of ≤30º on both sides. In addition, implants placed in the molar region had a significantly wider EA and more frequent convex profiles than those placed in the premolar region.</div></div><div><h3>Conclusions</h3><div>MRONJ affected dental implants may be associated with crestal module design. In addition, implant prosthesis characteristics may influence MRONJ occurrence depending on the implant design, and in patients receiving antiresorptive therapy, implant design should be carefully planned with consideration of the anatomical location to minimize the risk of MRONJ.</div></div><div><h3>Clinical Significance</h3><div>Implant design should be considered when planning implant treatment in patients receiving antiresorptive therapy, especially in anatomically vulnerable areas such as the molar region.</div></div>","PeriodicalId":15585,"journal":{"name":"Journal of dentistry","volume":"163 ","pages":"Article 106133"},"PeriodicalIF":5.5000,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of dentistry","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0300571225005792","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"DENTISTRY, ORAL SURGERY & MEDICINE","Score":null,"Total":0}

引用次数: 0

Abstract

Purpose

This study aimed to identify risk factors associated with medication-related osteonecrosis of the jaw (MRONJ) around dental implants, focusing on implant/prosthesis characteristics and peri-implantitis.

Methods

This retrospective study included 355 dental implants obtained from 67 patients, each with at least one implant affected by MRONJ, who visited Yonsei University Dental Hospital between January 2008 and March 2022. The outcome variable was the presence or absence of MRONJ. Predictor variables included implant location, crestal module design, prosthesis type, emergence profile, emergence angle (EA), and peri-implantitis. A generalized estimating equation model was used to adjust for within-patient clustering effects.

Results

A total of 355 implants were analyzed, of which 112 implants were affected by MRONJ and 243 were not affected. External-type implants had higher odds of MRONJ than tissue-level implants (OR, 4.07; 95 % CI, 1.23–13.45). The odds of MRONJ were higher in implants with peri-implantitis compared to those without peri-implantitis (OR, 7.43; 95 % CI, 2.74–20.14). In tissue-level implants, MRONJ was significantly associated with a convex profile (39.1 %) than in those with straight or concave profiles (15.8 %). In bone-level implants, MRONJ was significantly higher in prostheses with an EA of >30º on at least one side, compared to those with EA of ≤30º on both sides. In addition, implants placed in the molar region had a significantly wider EA and more frequent convex profiles than those placed in the premolar region.

Conclusions

MRONJ affected dental implants may be associated with crestal module design. In addition, implant prosthesis characteristics may influence MRONJ occurrence depending on the implant design, and in patients receiving antiresorptive therapy, implant design should be carefully planned with consideration of the anatomical location to minimize the risk of MRONJ.

Clinical Significance

Implant design should be considered when planning implant treatment in patients receiving antiresorptive therapy, especially in anatomically vulnerable areas such as the molar region.

查看原文本刊更多论文

种植体周围颌骨的药物相关性骨坏死与种植体设计和假体特性有关吗？

目的：本研究旨在确定种植体周围药物相关性颌骨骨坏死（MRONJ）的相关危险因素，重点关注种植体/假体特征和种植体周围炎。方法：本回顾性研究包括67名患者的355颗种植体，每位患者至少有一颗种植体受到MRONJ的影响，这些患者于2008年1月至2022年3月期间在延世大学牙科医院就诊。结果变量为MRONJ的存在与否。预测变量包括种植体位置、牙冠模块设计、假体类型、出现轮廓、出现角度（EA）和种植体周围炎。采用广义估计方程模型对患者内聚类效应进行调整。结果：共分析355个种植体，其中MRONJ影响种植体112个，未影响种植体243个。外置型种植体发生MRONJ的几率高于组织级种植体（OR, 4.07; 95% CI, 1.23-13.45）。有种植体周围炎的种植体发生MRONJ的几率高于无种植体周围炎的种植体（OR, 7.43; 95% CI, 2.74-20.14）。在组织水平种植体中，MRONJ与凸型（39.1%）显著相关，而与直型或凹型（15.8%）相关。在骨水平种植体中，与两侧EA≤30º的种植体相比，至少一侧EA≤30º的种植体的MRONJ显著高于两侧EA≤30º的种植体。此外，放置在磨牙区域的种植体比放置在前磨牙区域的种植体具有更宽的EA和更频繁的凸轮廓。结论：受MRONJ影响的种植体可能与牙冠模设计有关。此外，种植体假体的特点可能会影响MRONJ的发生，这取决于种植体的设计，在接受抗吸收治疗的患者中，种植体的设计应仔细考虑其解剖位置，以尽量减少MRONJ的风险。临床意义：在计划接受抗吸收治疗的患者种植体治疗时，应考虑种植体的设计，特别是在解剖上脆弱的区域，如磨牙区。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Journal of dentistry 医学-牙科与口腔外科

CiteScore

7.30

自引率

11.40%

发文量

349

审稿时长

35 days

期刊介绍： The Journal of Dentistry has an open access mirror journal The Journal of Dentistry: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. The Journal of Dentistry is the leading international dental journal within the field of Restorative Dentistry. Placing an emphasis on publishing novel and high-quality research papers, the Journal aims to influence the practice of dentistry at clinician, research, industry and policy-maker level on an international basis. Topics covered include the management of dental disease, periodontology, endodontology, operative dentistry, fixed and removable prosthodontics, dental biomaterials science, long-term clinical trials including epidemiology and oral health, technology transfer of new scientific instrumentation or procedures, as well as clinically relevant oral biology and translational research. The Journal of Dentistry will publish original scientific research papers including short communications. It is also interested in publishing review articles and leaders in themed areas which will be linked to new scientific research. Conference proceedings are also welcome and expressions of interest should be communicated to the Editor.