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A critical assessment of the medication-related osteonecrosis of the jaw classification in stage I patients: a retrospective analysis

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Ristow Oliver, Hurtgen Lena, Moratin Julius, Smielowski Maximilian, Freudlsperger Christian, Engel Michael, Hoffmann Jurgen, Ruckschlob Thomas,
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 ( Ristow Oliver ) - University of Heidelberg Department of Oral and Maxillofacial Surgery
 ( Hurtgen Lena ) - University of Heidelberg Department of Oral and Maxillofacial Surgery
 ( Moratin Julius ) - University of Heidelberg Department of Oral and Maxillofacial Surgery
 ( Smielowski Maximilian ) - University of Heidelberg Department of Oral and Maxillofacial Surgery
 ( Freudlsperger Christian ) - University of Heidelberg Department of Oral and Maxillofacial Surgery
 ( Engel Michael ) - University of Heidelberg Department of Oral and Maxillofacial Surgery
 ( Hoffmann Jurgen ) - University of Heidelberg Department of Oral and Maxillofacial Surgery
 ( Ruckschlob Thomas ) - University of Heidelberg Department of Oral and Maxillofacial Surgery

Abstract


Objectives: It is unclear whether the extent of intraoral mucosa defects in patients with medication-related osteonecrosis of the jaw indicates disease severity. Therefore, this study investigated whether mucosal lesions correlate with the true extent of osseous defects in stage I patients.

Materials and Methods: Retrospectively, all patients with stage I medication-related osteonecrosis of the jaw who underwent surgical treatment between April 2018 and April 2019 were enrolled. Preoperatively, the extent of their mucosal lesions was measured in clinical evaluations, and patients were assigned to either the visible or the probeable bone group. Intraoperatively, the extent of necrosis was measured manually and with fluorescence.

Results: Fifty-five patients (36 female, 19 male) with 86 lesions (46 visible bone, 40 probeable bone) were enrolled. Intraoperatively, the necrotic le-sions were significantly larger (P<0.001) than the preoperative mucosal lesions in both groups. A significant (P<0.05) but very weak (R2<0.2) relation-ship was noted between the extent of the mucosal lesions and the necrotic bone area.

Conclusion: Preoperative mucosal defects (visible or probeable) in patients with medication-related osteonecrosis of the jaw do not indicate the extent of bone necrosis or disease severity.

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Medication-related osteonecrosis of the jaw; Bisphosphonate-related osteonecrosis of the jaw; Antiresorptiva-related osteonecrosis of the jaw; Definition; Classification

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