Saliva Acidity in Cancer Patients at Risk for MRONJ Receiving Long Term Bisphosphonate Therapy

Abstract

Medication related osteonecrosis of the jaw (MRONJ) lacks a defined pathophysiologic mechanism, however, many mechanisms have been proposed including local tissue acidification within the jaws playing a key role in the pathogenesis of the disease [1]. Based on evidence that acidic environments result in the release of bisphosphonate (BP) from bone we sought to measure salivary pH levels in patients with MRONJ and compare these salivary pH levels against patients with resolved MRONJ lesions, patients with a history of BP therapy but without MRONJ and matched controls (no history of malignancy or BP exposure) [2]. We hypothesized that patients treated with bisphosphonate therapy for malignancy who subsequently developed MRONJ would have a more acidic oral cavity environment.