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Relevant factors for treatment outcome and time to healing in medication-related osteonecrosis of the jaws – A retrospective cohort study
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Orientador(es)
Resumo(s)
Background: Risk factors for medication-related osteonecrosis of the jaw (MRONJ) are well known, although few studies evaluate the factors that influence treatment outcomes in MRONJ and whether discontinuing antiresorptive medication influences healing.
Purpose: (1) Describe the characteristics of a population of patients with MRONJ. (2) Identify the factors associated with favourable outcomes. (3) Identify a temporal correlation between discontinuation of antiresorptives and healing time.
Methods: A retrospective longitudinal cohort study was carried out, including 77 patients with MRONJ treated between 2004 and 2016. Primary outcome was defined as healed/improved vs. worse/stable. Time to healing was set as the secondary outcome. Statistical significance was defined as p < 0.05.
Results: Primary disease, route of administration, lesion location, and development of complications influenced the outcome of treatment. Significant differences in outcomes according to primary disease (p < 0.05) were found when staging, gender, and lesion location were held constant. Time to healing was longer for patients who discontinued medication more than 3 months after diagnosis than for those who discontinued at diagnosis or before - respectively, 36, 9, and 7 months (p = 0.01).
Conclusions: The outcome of MRONJ treatment may be influenced by primary disease and route of administration of antiresorptives. Antiresorptive medication discontinuation contributes to reduce healing time in MRONJ.
Descrição
Palavras-chave
Bisphosphonates Denosumab MRONJ Osteonecrosis Sunitinib
Contexto Educativo
Citação
J Craniomaxillofac Surg . 2017 Oct;45(10):1736-1742. doi: 10.1016/j.jcms.2017.07.014
Editora
Elsevier