Abstract
IntroductionMedication-related osteonecrosis of the jaws (MRONJ) is generally described as rare; therefore, firm incidence data are challenging to ascertain.AimUsing two sites in Northwest England, ascertain the number of referrals to oral and maxillofacial surgery involving:Suspected MRONJ.Patients at risk of MRONJ requiring a dentoalveolar procedure.MethodAll sequential referrals over a 2-year period were analysed. The referrals were categorised into ‘type’ of referral (stage 1). Any referral for MRONJ, or patient at risk, was then further examined (stage 2).ResultsA total of 2150 referrals were screened. The most common referral reasons were temporomandibular joint issues and hard tissue conditions. The proportion of referrals for suspected MRONJ was similar for both sites: 3.7% (site 1) and 3.4% (site 2). At site 1, 1.6% of all referrals were at risk of MRONJ referred for treatment. In site 2, 3.8% of all referrals were in this category.ConclusionDespite limitations, the finding that patients with or at risk of MRONJ potentially equates to 7% of all referrals represents a substantial proportion of OMFS practice. Therefore, there are clear benefits of collecting accurate data prospectively to understand the scale of this condition and its impact on services.
Highlights
Medication-related osteonecrosis of the jaws (MRONJ) is generally described as rare; firm incidence data are challenging to ascertain
Despite limitations, the finding that patients with or at risk of MRONJ potentially equates to 7% of all referrals represents a substantial proportion of OMFS practice
The nomenclature has evolved from bisphosphonate-related ONJ to antiresorptive-related ONJ to MRONJ, reflecting the implication of drugs other than bisphosphonates in the development of MRONJ, namely antiresorptive and some antiangiogenic medications [2]
Summary
Medication-related osteonecrosis of the jaws (MRONJ) is generally described as rare; firm incidence data are challenging to ascertain. ● Patients at risk of MRONJ requiring a dentoalveolar procedure. Medication-related osteonecrosis of the jaws (MRONJ) was first described in 2003 by Marx et al [1]. MRONJ is generally described as rare; it is not an uncommon presentation to oral surgery and oral and maxillofacial surgery units [2,3,4,5,6,7]. The risk of MRONJ is largely estimated at less than 1% of those at risk [8] and influenced by numerous factors such as indication for the implicated drug, modality of drug, extent of any dentoalveolar surgery carried out and co-morbidities, etc. The risk of MRONJ is largely estimated at less than 1% of those at risk [8] and influenced by numerous factors such as indication for the implicated drug, modality of drug, extent of any dentoalveolar surgery carried out and co-morbidities, etc. [9, 10]
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