Hidenobu Sakuma, Hiroko Kanemaru, Akira Kurokawa, Marie Soga, Moe Yamashita, Mai Nozawa-Kobayashi, Kanae Niimi, Tadaharu Kobayashi
{"title":"糖皮质激素所致骨质疏松症患者接受抗吸收药物治疗时MRONJ的患病率。","authors":"Hidenobu Sakuma, Hiroko Kanemaru, Akira Kurokawa, Marie Soga, Moe Yamashita, Mai Nozawa-Kobayashi, Kanae Niimi, Tadaharu Kobayashi","doi":"10.1007/s10006-025-01383-x","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>In this study, we aimed to investigate the incidence of medication-related osteonecrosis of the jaw (MRONJ) in patients with glucocorticoid-induced osteoporosis (GIOP) and to examine risk factors for MRONJ development, as well as the preventive effect of tooth extraction before antiresorptive agent (ARA) administration.</p><p><strong>Methods: </strong>This retrospective study included patients who received ARA to prevent fragility fractures due to GIOP. The cumulative incidence of MRONJ in patients with GIOP was calculated using the Kaplan-Meier method. Univariate and multivariate Cox regression analyses were used to analyze risk factors for MRONJ occurrence.</p><p><strong>Results: </strong>The study included 327 individuals. Six patients developed MRONJ; the crude incidence of MRONJ was 1.8%, and the cumulative incidence at 1, 2, 3, 4, and 5 years was 0.32%, 0.97%, 1.35%, 1.85%, and 2.56%, respectively. In this study, 159 teeth were extracted during dental intervention before ARA administration in 58 patients; however, no MRONJ development was observed at the extraction site. Tooth extraction, diabetes mellitus, and duration of ARA administration were not identified as risk factors in this study.</p><p><strong>Conclusions: </strong>The incidence of MRONJ in patients with GIOP was higher than the previously reported incidence in patients with age-related osteoporosis but lower than the incidence in patients using high-dose ARA. The results support the effectiveness of prophylactic procedures to remove the infected lesions as much as possible from the jawbone and periodontal tissue before ARA administration.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":47251,"journal":{"name":"Oral and Maxillofacial Surgery-Heidelberg","volume":"29 1","pages":"84"},"PeriodicalIF":1.7000,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Prevalence of MRONJ in patients treated with antiresorptive agents for glucocorticoid-induced osteoporosis.\",\"authors\":\"Hidenobu Sakuma, Hiroko Kanemaru, Akira Kurokawa, Marie Soga, Moe Yamashita, Mai Nozawa-Kobayashi, Kanae Niimi, Tadaharu Kobayashi\",\"doi\":\"10.1007/s10006-025-01383-x\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>In this study, we aimed to investigate the incidence of medication-related osteonecrosis of the jaw (MRONJ) in patients with glucocorticoid-induced osteoporosis (GIOP) and to examine risk factors for MRONJ development, as well as the preventive effect of tooth extraction before antiresorptive agent (ARA) administration.</p><p><strong>Methods: </strong>This retrospective study included patients who received ARA to prevent fragility fractures due to GIOP. The cumulative incidence of MRONJ in patients with GIOP was calculated using the Kaplan-Meier method. Univariate and multivariate Cox regression analyses were used to analyze risk factors for MRONJ occurrence.</p><p><strong>Results: </strong>The study included 327 individuals. Six patients developed MRONJ; the crude incidence of MRONJ was 1.8%, and the cumulative incidence at 1, 2, 3, 4, and 5 years was 0.32%, 0.97%, 1.35%, 1.85%, and 2.56%, respectively. In this study, 159 teeth were extracted during dental intervention before ARA administration in 58 patients; however, no MRONJ development was observed at the extraction site. Tooth extraction, diabetes mellitus, and duration of ARA administration were not identified as risk factors in this study.</p><p><strong>Conclusions: </strong>The incidence of MRONJ in patients with GIOP was higher than the previously reported incidence in patients with age-related osteoporosis but lower than the incidence in patients using high-dose ARA. The results support the effectiveness of prophylactic procedures to remove the infected lesions as much as possible from the jawbone and periodontal tissue before ARA administration.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>\",\"PeriodicalId\":47251,\"journal\":{\"name\":\"Oral and Maxillofacial Surgery-Heidelberg\",\"volume\":\"29 1\",\"pages\":\"84\"},\"PeriodicalIF\":1.7000,\"publicationDate\":\"2025-04-16\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Oral and Maxillofacial Surgery-Heidelberg\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1007/s10006-025-01383-x\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"DENTISTRY, ORAL SURGERY & MEDICINE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Oral and Maxillofacial Surgery-Heidelberg","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1007/s10006-025-01383-x","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"DENTISTRY, ORAL SURGERY & MEDICINE","Score":null,"Total":0}
Prevalence of MRONJ in patients treated with antiresorptive agents for glucocorticoid-induced osteoporosis.
Purpose: In this study, we aimed to investigate the incidence of medication-related osteonecrosis of the jaw (MRONJ) in patients with glucocorticoid-induced osteoporosis (GIOP) and to examine risk factors for MRONJ development, as well as the preventive effect of tooth extraction before antiresorptive agent (ARA) administration.
Methods: This retrospective study included patients who received ARA to prevent fragility fractures due to GIOP. The cumulative incidence of MRONJ in patients with GIOP was calculated using the Kaplan-Meier method. Univariate and multivariate Cox regression analyses were used to analyze risk factors for MRONJ occurrence.
Results: The study included 327 individuals. Six patients developed MRONJ; the crude incidence of MRONJ was 1.8%, and the cumulative incidence at 1, 2, 3, 4, and 5 years was 0.32%, 0.97%, 1.35%, 1.85%, and 2.56%, respectively. In this study, 159 teeth were extracted during dental intervention before ARA administration in 58 patients; however, no MRONJ development was observed at the extraction site. Tooth extraction, diabetes mellitus, and duration of ARA administration were not identified as risk factors in this study.
Conclusions: The incidence of MRONJ in patients with GIOP was higher than the previously reported incidence in patients with age-related osteoporosis but lower than the incidence in patients using high-dose ARA. The results support the effectiveness of prophylactic procedures to remove the infected lesions as much as possible from the jawbone and periodontal tissue before ARA administration.
期刊介绍：
Oral & Maxillofacial Surgery founded as Mund-, Kiefer- und Gesichtschirurgie is a peer-reviewed online journal. It is designed for clinicians as well as researchers.The quarterly journal offers comprehensive coverage of new techniques, important developments and innovative ideas in oral and maxillofacial surgery and interdisciplinary aspects of cranial, facial and oral diseases and their management. The journal publishes papers of the highest scientific merit and widest possible scope on work in oral and maxillofacial surgery as well as supporting specialties. Practice-oriented articles help improve the methods used in oral and maxillofacial surgery.Every aspect of oral and maxillofacial surgery is fully covered through a range of invited review articles, clinical and research articles, technical notes, abstracts, and case reports. Specific topics are: aesthetic facial surgery, clinical pathology, computer-assisted surgery, congenital and craniofacial deformities, dentoalveolar surgery, head and neck oncology, implant dentistry, oral medicine, orthognathic surgery, reconstructive surgery, skull base surgery, TMJ and trauma.Time-limited reviewing and electronic processing allow to publish articles as fast as possible. Accepted articles are rapidly accessible online.Clinical studies submitted for publication have to include a declaration that they have been approved by an ethical committee according to the World Medical Association Declaration of Helsinki 1964 (last amendment during the 52nd World Medical Association General Assembly, Edinburgh, Scotland, October 2000). Experimental animal studies have to be carried out according to the principles of laboratory animal care (NIH publication No 86-23, revised 1985).
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