The effect of chronic dental inflammation on development of stage 0 medication-related osteonecrosis of the jaw

Publication date: Available online 12 May 2017
Source:Journal of Cranio-Maxillofacial Surgery
Author(s): Goknur Topaloglu, Osman Taha Koseoglu, Cigdem Karaca, Kemal Kosemehmetoglu
ObjectiveThe pathogenesis of medication-related osteonecrosis of jaw (MRONJ) is poorly understood. The aim of this prospective study was to determine the effect of chronic dental inflammation on the development of stage 0 MRONJ based on histopathological findings.MethodsThe study involved patients with a history of bisphosphonate use and an indication for tooth extraction. Before surgery, C-terminal telopeptide test (CTX) values were collected from all patients. All tooth extractions were performed according to a determined protocol. To detect whether any medication-related osteonecrotic changes were present in the non-exposed bone, biopsy samples were taken from the alveolar bone.ResultsA total of 50 patients were included in the study (39 women and 11 men). The patients were mean age of 57.4 ± 12.1 years. In total, 74 teeth were extracted (29 maxillary and 45 mandibular). Histologic examination of three patients (6%) revealed stage 0 MRONJ. Postoperatively, the complete mucosal healing success rate was 96%. MRONJ risk was not significantly correlated with low CTX value (p = 0.285).ConclusionsChronic inflammation may contribute to stage 0 MRONJ; however, its role may not be sufficient alone for its development. Application of a predetermined protocol for dentoalveolar processes will help to prevent MRONJ development.



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