Evaluation der Lebensqualität von Patienten mit Antiresorptiva-assoziierten Kiefernekrosen bei chirurgischen Therapiemaßnahmen

Abstract

Medication-related osteonecrosis of the jaw (MRONJ) is a disease for which both the cause and the impact on the quality of life of affected patients are poorly understood. The aim of this study was to investigate the quality of life of patients with MRONJ in stages 2 or 3 during surgical therapy. To achieve this goal, 27 patients were examined, treated, and surveyed about their quality of life multiple times between May 2020 and December 2021. The personal survey was conducted using two validated questionnaires, the short form 12 and the oral health impact profile 14, in order to investigate the difference between changes in overall health-related quality of life and changes in oral health-related quality of life. Both patient-related data and the results of the five surveys conducted over a period of six months were evaluated descriptively. Significance calculations for the results of both questionnaires were performed using the Friedman and Cochran-Q tests. Overall health-related quality of life, as measured by the results of the short form 12, showed a significant (p < 0.001) improvement in four of the eight categories among the 27 patients. While men reported a mostly better quality of life when gender was taken into account, there was no significant difference between malignant and non-malignant diseases when the underlying disease was considered. Oral health-related quality of life, as assessed by the oral health impact profile 14, showed a significant (p < 0.001) improvement in the overall group and a significant improvement in 11 of the 14 questions when individual items were examined. Men also reported significantly better quality of life than women in this category, while the distinction between underlying diseases yielded similar results as mentioned above. The changes in both overall health-related and oral health-related quality of life showed a predominantly simultaneous course. In almost all categories of the short form 12 or individual items of the oral health impact profile 14, quality of life initially deteriorated in the week after surgical removal of MRONJ, but steadily improved from the third survey onward. In the long term, patients reported a significant improvement in both components of quality of life compared to the period before therapy. In conclusion, surgical therapy for MRONJ leads to an improvement in quality of life, and oral health-related quality of life changes and improves more significantly than overall health-related quality of life when examined in a differentiated manner. All three working hypotheses of this study were thus confirmed. To obtain even more meaningful results in the future regarding the changes in quality of life due to surgical therapy in patients with MRONJ, studies of this kind should be conducted with a larger patient population.