التفاصيل البيبلوغرافية
| العنوان: |
Medication-Related Osteonecrosis of the Jaw: Prevalence of Extra-Oral Signs as a Presenting Complaint? |
| المؤلفون: |
WHITEFIELD, SARA, ILAN, MOR BAR, LAZAROVICI, TOWY SOREL, YAROM, NOAM |
| المصدر: |
Oral Surgery, Oral Medicine, Oral Pathology & Oral Radiology; Feb2023, Vol. 135 Issue 2, pe44-e45, 2p |
| مستخلص: |
Objectives: Our study aims to highlight the possible extra-oral presentation of patients with Medication-Related Osteonecrosis of the Jaw (MRONJ). Methods: All files of patients diagnosed with MRONJ between 2003 and June 2020 in the Oral and Maxillofacial Surgery Department and the Oral Medicine Unit in the Sheba Medical Center, Israel, were retrieved. Data on demographics, medical background, type, and duration of drug use, triggering events at presentation and clinical presentation was collected. Results: The study included 516 patients who met the inclusion criteria, 379 females (73%) and 137 males (27%), with a mean age of 65 years (range: 32-94 years). Of the 516 patients presenting with MRONJ 78 presented with extra-oral manifestations of swelling or erythema. Of these 78, 22 patients presented with extra-oral fistulas. In patients presenting with extra-oral manifestations of MRONJ, 77% were seen associated with the mandible and 13% with the maxilla (p=0.003). In the osteoporosis group of patients with extraoral signs of MRONJ, 90% were seen associated with the mandible and 2% with the maxilla (p=0.016). In the oncology group of patients with extra-oral signs of MRONJ, 71% were seen associated with the mandible and 19% with the maxilla (p=0.07). The remainder showed evidence of MRONJ in both jaws. Overall, 82% of patients who showed extra-oral signs presented with swelling (p-value <0.001), 24% presented with an extra-oral fistula (p-value <0.001). In the osteoporosis group, 76% of patients who showed extra-oral signs presented with swelling (p-value <0.001), 29% presented with an extra-oral fistula (p-value <0.001). In the oncology group, 85% of patients who showed extra-oral signs presented with swelling (p-value <0.001), 22% presented with an extra-oral fistula (p-value <0.001). Diabetes and smoking were not found to be a risk factor of extra-oral signs of MRONJ at presentation. Conclusion: Medication related osteonecrosis of the jaws is a significant side-effect of taking bone modifying agents. Although, most commonly presenting intra-orally, we have seen in our study that a significant number of patients will initially present with extra-oral signs of swelling, erythema, or fistulas. Therefore, it is important for health care professionals, including dentists to be aware of this presentation of MRONJ. [ABSTRACT FROM AUTHOR] |
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