Risk factors for medication-related osteonecrosis of the jaws in menopausal women

Abstract

Aim  This study aimed to identify risk factors for medication-related osteonecrosis of the jaw (MRONJ) by carrying out clinical and radiographic evaluations of patients with osteopenia and osteoporosis using bisphosphonates (BFs).

Methods  After approval by the CCS/UFES Ethics Committee (registration number 2,738,749), consultations were undertaken, and data were collected from medical records in cooperation with sectors from UFES and the University hospital. A total of 50 patients, 29 with osteoporosis and 21 with osteopenia were selected. Patients underwent a clinical and a panoramic dental x-ray examination to assess risk factors associated with oral health and dental interventions.

Results  All patients had at least one local risk factor, the most frequent being tooth extraction (100%) and periodontal disease (50%) which, if associated with the use of BFs, could lead to MRONJ. Among the systemic risk factors, the most common were diabetes and corticosteroid therapy. The most used BF was alendronate, administered orally.

Conclusion  The dental surgeon should evaluate all patients with osteopenia and osteoporosis using BFs to determine whether there are other risks. Whether there may be other potential risks, acknowledging upon key risks factors surrounding MRONJ are critical for early diagnosis and successful dental treatment.

Osteoporosis; Bisphosphonate-associated osteonecrosis of the jaw; Risk factors; Jaw