Abstract
PurposeThe treatment of advanced stages of medication-related osteonecrosis of the jaw (MRONJ) remains challenging. In order to improve decision making concerning the therapy, we examined the change of patients’ quality of life (QoL) after surgical treatment of MRONJ stage III.MethodThe primary outcome variable was patients’ QoL. It was preoperative (T0), 6 weeks postoperative (T1) and 6 months postoperative (T2) assessed by the European Organisation for Research and Treatment of Cancer QoL-H&N35 (EORTC QoL-H&N35) and the Oral Health Impact Factor-G14 (OHIP-G14) questionnaire in a prospective cohort study. Other variables included location, age, sex, risk factors, and recurrence. Descriptive statistics and general multivariate regression models were calculated.ResultsForty-three patients with stage III MRONJ underwent surgery. OHIP-G14 scores decreased (improvement) statistically significant (p = .001) by 52.02% (T0-T1) and 56.45% (T1–T2). EORTC QoL-H&N35 showed statistical improvement for “swallowing” (p = .007), “opening mouth” (p = .045), “painkiller” (.005), “weight loss” (.004), “pain” (p = .001), “trouble with social eating” (p = .001), “trouble with social contact” (p = .001), and “teeth” (p = .001). Patients who developed a recurrence did not show any significant higher (worse) scores in OHIP G14 or EORTC QoL-H&N35 scores compared with patients without recurrence. Twenty-nine out of 36 patients showed full mucosal healing (T2). For patients with no full mucosal healing, a downgrade to stage I was achieved.ConclusionIn terms of QoL patients with stage III MRONJ do benefit from surgical treatment. The incident of a recurrence seems to have no significant impact on patients QoL.
Highlights
Since the first appearance in 2003 medication-related osteonecrosis of the jaw (MRONJ) remains challenging for clinicians and patients [1]
Oral Maxillofac Surg (2021) 25:359–366 detect the impact of a recurrence on the change in quality of life (QoL), and (3) to estimate the effect of covariates such as age, sex, medication, duration of medication, location of MRONJ, and risk factors
The location of the MRONJ did not show a significant impact on the risk of developing a relapse (T1 p = .624; T2 p = .652)
Summary
Since the first appearance in 2003 medication-related osteonecrosis of the jaw (MRONJ) remains challenging for clinicians and patients [1]. With the growing number of drugs causing MRONJ and the still not fully resolved pathology, it is part of ongoing controversies. Current treatments rely on position papers as there is no international standard guideline available until today [2,3,4,5]. The treatment of stage III patients has shown to be a major challenge because despite. Oral Maxillofac Surg (2021) 25:359–366 detect the impact of a recurrence on the change in QoL, and (3) to estimate the effect of covariates such as age, sex, medication, duration of medication, location of MRONJ, and risk factors
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