Nonexposed Antiresorptive Agent-related Osteomyelitis of the Jaw: a Single-center Cohort Study

Overview

Journal J Bone Miner Metab

Specialty Endocrinology

Date 2022 May 9

PMID 35534635

Authors

Takuma Watanabe

Takeshi Yoshida

Sachi Akizuki

Shigeki Yamanaka

Kazumasa Nakao

Shizuko Fukuhara

Keita Asai

Ryuji Uozumi

Kazuhisa Bessho

Affiliations

Soon will be listed here.

Abstract

Introduction: The nonexposed variant of antiresorptive agent-related osteonecrosis of the jaw (ARONJ) presents with nonspecific clinical findings. The diagnosis of nonexposed ARONJ poses a critical challenge, and there is little evidence regarding its treatment and outcomes. This study aimed to examine the clinical outcomes in patients with nonexposed antiresorptive agent-related osteomyelitis of the jaw (AROMJ). The terms ARONJ and AROMJ were used separately in this study.

Materials And Methods: We enrolled patients with nonexposed AROMJ (osteomyelitis of the jaw without bone exposure associated with antiresorptive agents) with partial reference to an existing position paper on ARONJ. The initiating event of osteomyelitis was limited to periodontitis. Based on the findings of bone scintigraphy, panoramic radiography, computed tomography, and histopathological examination, we also used the hierarchical diagnostic criteria (HDC) for osteomyelitis of the jaw.

Results: There were 58 confirmed cases of nonexposed AROMJ based on the HDC. All patients had sufficient clinical findings to be diagnosed with nonexposed AROMJ as osteomyelitis underwent extraction with bone debridement. The healing rate was 93.1% (54/58). Univariable analysis showed a strong association between the healing status and malignant disease, while multivariable analysis showed no strong association between them.

Conclusions: The present study had a relatively large sample size of patients with nonexposed AROMJ. The primary disease in patients with nonexposed AROMJ may not have a strong association with the healed status of the lesion. Based on its high healing rate, extraction with bone debridement in confirmed nonexposed AROMJ may prevent progression.

Citing Articles

Pathophysiology of Medication-Related Osteonecrosis of the Jaw-A Minireview.

Tetradis S, Allen M, Ruggiero S JBMR Plus. 2023; 7(8):e10785.

PMID: 37614299 PMC: 10443081. DOI: 10.1002/jbm4.10785.

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