Comparison of non-medication-related osteonecrosis and medication-related osteonecrosis of the jaw: a pilot study.

OBJECTIVES

This study aimed to compare composite radiographic index (CRI-index) findings of medication-related osteonecrosis of jaws (MRONJs) and non-medication related osteonecrosis of jaws (n-MRONJs) and predict factors predictive of recurrence and healing delays.

MATERIALS AND

METHODS

Patients referred to our clinic for stage 2 and 3 MRONJ and n-MRONJ between 2020 and 2023 were included in this study. Microorganisms were isolated in samples of excised bone obtained from the adjacent bone by surgery. CRI-index was evaluated using radiological data. Patient age, sex, causes and localization of osteomyelitis, as well as intraoperative and postoperative complications were recorded.

RESULTS

There were no statistically significant differences in CRI-index score between the two groups (P>0.05). Presence of actinomyces colonies was not a significant predictor of recurrence or healing status. Furthermore, the presence of actinomyces colonies was not predictive of recurrence in the MRONJ group (P=0.035); however, the use of the antiresorptive agent denasumab was found to be a risk factor for recurrence in the MRONJ group (P=0.035).

CONCLUSION

Radiological and clinical findings were similar for MRONJ and n-MRONJ patients. However, although treatment methods for these two groups is almost identical, the follow-up process can vary. Actinomyces presence was not a predictive factor for recurrence of any type of osteonecrosis. To predict recurrence and healing delays, more parameters need to be investigated.