Evaluating the efficacy of surgical and non-surgical treatment modalities in the management of medication-related osteonecrosis of the jaw: a retrospective study.

OBJECTIVE

Our primary goal is to examine the efficacy of surgical and non-surgical therapy in treating Medication-related osteonecrosis of the jaw (MRONJ).

STUDY

DESIGN

Retrospective data were obtained from patients treated between 1st June 2011 to 1st December 2021. Included patients were classified into surgical and non-surgical therapy. The primary outcome measure is to assess the treatment's effect on the disease stage. Secondary outcome measures include the time to mucosalisation, exposed bone area, presence of infection, improvement in pain and paraesthesia, and qualitative assessment of radiographic presentation.

RESULTS

48 patients with 57 MRONJ sites were included in this study. The mean follow-up duration was 30.2 months (SD = 25 months). Neither smoking, alcohol use, nor any of the comorbidities significantly affected the treatment outcome of the disease. The drug administration mode influenced the treatment outcome (p = 0.00413). MRONJ lesions that were treated with surgery displayed statistically significant improvement (p = 0.018) in disease staging. The time taken for mucosalisation was faster after surgery (p = 0.00052). Regarding secondary outcomes, surgical therapy resulted in a significant improvement in the resolution of purulence (p = 0.041). No significant difference was observed for radiographic healing, exposed bone area, or pain.

CONCLUSION

Surgical therapy results in significant clinical improvement of MRONJ lesions compared to non-surgical therapy. However, non-surgical therapy can effectively prevent disease progression. Depending on the therapeutic goals, both treatment modalities are appropriate for managing MRONJ.