OSCAR-Assessing Individual Risk Profiles of MRONJ Patients.

OBJECTIVE

To develop an individual assessment for patients suffering from medication-related osteonecrosis of the jaw (MRONJ), we developed a scoring system that integrates anamnestic, clinical, and radiological parameters to facilitate the process of therapeutic decisions during MRONJ therapy.

METHODS

In this study, clinical data as well as diagnostic CT scans from 41 MRONJ patients undergoing antiresorptive therapy were analyzed to develop an Osteonecrosis Scoring Clinical Assessment and Radiological Report (OSCAR).

RESULTS

Total OSCAR scores ranged from 4 to 30, with lower scores demonstrating less severe disease progression following a de-escalated therapy. OSCAR scores above 15 were associated with higher bone density and an increased need for surgical intervention, with 70% of Denosumab and 71% of bisphosphonate patients requiring surgical intervention.

CONCLUSIONS

Patients with an OSCAR below 12 were unlikely to require multiple surgical interventions. Since OSCAR parameters are routinely collected during hospitalization, this opens the possibility for future AI-assisted patient assessment and treatment planning.