Osteonecrosis of the jaws: a 14-year retrospective survey of hospital admissions.
Aust Dent J. 2018 Feb 12;: Authors: McGowan K, Ivanovski S, Acton C
BACKGROUND: Osteonecrosis of the jaw (ONJ) is a serious complication of both radiation and antiresorptive therapies. This study aimed to determine how many patients have been treated for medication-related osteonecrosis of the jaws (MRONJ) and osteoradionecrosis (ORN), and whether the number of diagnoses has decreased over time with improved awareness and preventative measures. METHODS: Medical records at the Royal Brisbane & Women's Hospital, Gold Coast University Hospital, and Robina Hospital were reviewed to identify patients diagnosed with MRONJ and ORN between January 2003 - May 2017. Data on patient demographics, year of admission, and primary disease were analysed. RESULTS: 238 patients were diagnosed with ONJ, of which 74.4% were ORN and 25.6% were MRONJ. Tongue (24.6%), floor of mouth (17.3%), and tonsillar (15.1%) squamous cell carcinomas were the most common primary diseases associated with ORN, with a strong male predominance (80%). 52.5% of patients diagnosed with MRONJ were taking low-dose antiresorptives for osteoporosis (44.2%), rheumatoid arthritis (4.6%) or Paget's disease (3.3%), while 47.5% were oncology patients receiving high-dose antiresorptives. CONCLUSIONS: The number of patients diagnosed with MRONJ and ORN has trended upwards since 2003. ORN affected three times more patients than MRONJ, and patients on low-dose antiresorptives accounted for over half of the MRONJ cases. This article is protected by copyright. All rights reserved. PMID: 29432652 [PubMed - as supplied by publisher]