[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-detail-37290-en":3,"doc-seo-37290-105":30,"detail-sidebar-cat-0-en-105":83},{"code":4,"msg":5,"data":6},0,"success",{"doc_id":7,"user_id":8,"nickname":9,"user_avatar":10,"doc_module":4,"category_id":11,"category_name":12,"doc_title":13,"doc_description":14,"doc_content":15,"file_id":16,"file_url":17,"file_type":18,"file_size":19,"view_count":20,"is_deleted":4,"is_public":21,"is_downloadable":21,"audit_status":21,"page_count":22,"language":23,"language_code":24,"site_id":25,"html_lang":24,"table_of_contents":26,"faqs":27,"seo_title":13,"seo_description":14,"update_tm":28,"read_time":29},37290,962075114101,"Seraphina","https://ap-avatar.wpscdn.com/avatar/e000253a75eb197efd?x-image-process=image/resize,m_fixed,w_180,h_180&k=1780044092746381165",7,"Healthcare","Risk Factors of Medication-Related Osteonecrosis of the Jaw","Medication-related osteonecrosis of the jaw (MRONJ) is an intractable condition triggered by drugs such as bisphosphonates and denosumab, with increasing clinical impact on patients’ quality of life. The study compares MRONJ incidence and composition over two 5-year periods (2012–2016 vs 2017–2021) in a single hospital. It further evaluates adverse prognostic factors in 166 at-risk patients undergoing tooth extraction, identifying denosumab as a significant predictor of delayed healing.","J Stomatol Oral Maxillofac Surg 125 (2024) 101791  \nAvailable online at  \nScienceDirect  \n[www.sciencedirect.com](www.sciencedirect.com)  \n| Original Article\u003Cbr>Risk factors of medication-related osteonecrosis of the jaw: A clinical investigation |  |  |  |\n| --- | --- | --- | --- |\n| Yuko Komatsua, Tadashi Kawaia,*, Taifu Hiranoa, Isao Hoshia, Genki Yamayaa, Atsushi Ogawaa, Toshimi Chibab, Hiroyuki Yamadaa\u003Cbr>a Division of Oral and Maxillofacial Surgery, Department of Reconstructive Oral and Maxillofacial Surgery, School of Dentistry, Iwate Medical University, Japan b Division of Internal Medicine, Department of Oral Medicine, School of Dentistry, Iwate Medical University, Japan |  |  |  |\n| A R T I C L E I N F O |  | A B S T R A C T |  |\n| Article History:\u003Cbr>Received 15 January 2024\u003Cbr>Accepted 2 February 2024\u003Cbr>Available online 4 February 2024 |  | Medication-related osteonecrosis of the jaw (MRONJ) is an intractable condition caused by drugs such as bisphosphonates and denosumab. This study investigated the changes in the incidence of MRONJ in the previous 10 years and examined the poor prognostic factors during surgery in at-risk patients. We compared 57 and 64 patients diagnosed with MRONJ at our hospital between January 2012 and December 2016 and January 2017 and December 2021, respectively. The disease stage and triggers at the time of initial diagnosis ineligible patients were investigated. Additionally, the adverse prognostic factors were examined in 166 patients at risk of MRONJ who underwent tooth extraction at our department during these 10 years. The results indicated that there was no change in the proportion of patients with osteoporosis and malignancy among those with MRONJ. The number of cases after tooth extraction decreased, and those after dental infections increased on comparing the recent 5 years and the preceding 5 years. The number of MRONJ patients receiving denosumab also increased. Denosumab was a significant post-extraction prognostic factor for delayed healing in the 166 patients at risk ofMRONJ. The findings suggest that patients receiving denosumab should be closely monitored when undergoing surgery to prevent MRONJ.\u003Cbr>© 2024 Elsevier Masson SAS. All rights reserved. |  |\n| Key words: Bisphosphonates Denosumab Dental infection Medication Osteonecrosis |  |  |  |\n\n1. Introduction  \nMedication-related osteonecrosis of the jaw (MRONJ) has become one of the main diseases of the maxillofacial and oral regions [1,2]. With the progression of MRONJ, the symptoms and treatment affect the quality of life of patients [3]. Extensive bone resection or reconstruction may be required for some cases [4,5]. In 2003, Marx was the first to report the development of refractory osteonecrosis of the jaw after high-dose transvenous bisphosphonate (BP) formulations [6] . Bisphosphonate-related osteonecrosis of the jaw is caused by BP formulations, whereas denosumab-related osteonecrosis of the jaw is caused by denosumab (Dmab) formulations. Together, these conditions are called antiresorptive agent-related osteonecrosis of the jaw. Osteonecrosis of the jaw following the use of angiogenic inhibitors, including bevacizumab and sunitinib, has been also reported [7] . The 2014 American Association of Oral and Maxillofacial Surgeons (AAOMS) position paper (AAOMS 2014) reported all these cases of osteonecrosis as MRONJ [8]. Several position papers have been published nationally and internationally. Overseas, the AAOMS first  \n* Corresponding author. [E-mail address:](E-mail address: kawait@iwate-med.ac.jp)[ kawait@iwate-med.ac.jp](E-mail address: kawait@iwate-med.ac.jp) (T. Kawai).  \n[https://doi.org/10.1016/j.jormas.2024.101791](https://doi.org/10.1016/j.jormas.2024.101791)  \n2468-7855/© 2024 Elsevier Masson SAS. All rights reserved.  \npublished a position paper in 2007 [9], followed by updates in 2009 [10], 2014 [8], and 2022 [11].  \nSeveral groups have reported on the risk factors for MRONJ. Dmab has been associated with a","cbCaitjFVlloTYJt","https://ap.wps.com/l/cbCaitjFVlloTYJt","pdf",985104,3,1,8,"English","en",105,"# Introduction\n## Background of MRONJ and antiresorptive agents\n## Prior evidence and research gaps\n# Article purpose","[{\"question\":\"Which factor was linked to delayed healing after tooth extraction in at-risk patients?\",\"answer\":\"Denosumab was identified as a significant post-extraction prognostic factor for delayed healing among 166 at-risk patients undergoing tooth extraction.\"}]",1783026871,20,{"code":4,"msg":31,"data":32},"ok",{"site_id":25,"language":24,"slug":33,"title":13,"keywords":34,"description":14,"schema_data":35,"social_meta":78,"head_meta":80,"extra_data":82,"updated_unix":28},"risk-factors-of-medication-related-osteonecrosis-of-the-jaw","",{"@graph":36,"@context":77},[37,53,68],{"@type":38,"itemListElement":39},"BreadcrumbList",[40,44,48,50],{"item":41,"name":42,"@type":43,"position":21},"https://docshare.wps.com","Home","ListItem",{"item":45,"name":46,"@type":43,"position":47},"https://docshare.wps.com/document/","Document",2,{"item":49,"name":12,"@type":43,"position":20},"https://docshare.wps.com/document/healthcare/",{"item":51,"name":13,"@type":43,"position":52},"https://docshare.wps.com/document/risk-factors-of-medication-related-osteonecrosis-of-the-jaw/37290/",4,{"url":51,"name":13,"@type":54,"author":55,"headline":13,"publisher":57,"fileFormat":60,"inLanguage":24,"description":14,"dateModified":61,"datePublished":62,"encodingFormat":60,"isAccessibleForFree":63,"interactionStatistic":64},"DigitalDocument",{"name":9,"@type":56},"Person",{"url":41,"name":58,"@type":59},"DocShare","Organization","application/pdf","2026-07-09","2026-07-02",true,{"@type":65,"interactionType":66,"userInteractionCount":20},"InteractionCounter",{"@type":67},"ViewAction",{"@type":69,"mainEntity":70},"FAQPage",[71],{"name":72,"@type":73,"acceptedAnswer":74},"Which factor was linked to delayed healing after tooth extraction in at-risk patients?","Question",{"text":75,"@type":76},"Denosumab was identified as a significant post-extraction prognostic factor for delayed healing among 166 at-risk patients undergoing tooth extraction.","Answer","https://schema.org",{"og:url":51,"og:type":79,"og:title":13,"og:site_name":58,"og:description":14},"article",{"robots":81,"canonical":51},"index,follow",{"doc_id":7,"site_id":25},{"code":4,"msg":5,"data":84},[85,89,93,97,102,107,110,114,118,121,125],{"id":21,"doc_module":4,"doc_module_name":46,"category_name":86,"show_sort_weight":87,"slug":88},"Story & Novel",90,"story-novel",{"id":47,"doc_module":4,"doc_module_name":46,"category_name":90,"show_sort_weight":91,"slug":92},"Literature",80,"literature",{"id":52,"doc_module":4,"doc_module_name":46,"category_name":94,"show_sort_weight":95,"slug":96},"Exam",70,"exam",{"id":98,"doc_module":4,"doc_module_name":46,"category_name":99,"show_sort_weight":100,"slug":101},5,"Comic",60,"comic",{"id":103,"doc_module":4,"doc_module_name":46,"category_name":104,"show_sort_weight":105,"slug":106},6,"Technology",50,"technology",{"id":11,"doc_module":4,"doc_module_name":46,"category_name":12,"show_sort_weight":108,"slug":109},40,"healthcare",{"id":22,"doc_module":4,"doc_module_name":46,"category_name":111,"show_sort_weight":112,"slug":113},"Research & Report",30,"research-report",{"id":115,"doc_module":4,"doc_module_name":46,"category_name":116,"show_sort_weight":29,"slug":117},9,"Religion & Spirituality","religion-spirituality",{"id":29,"doc_module":4,"doc_module_name":46,"category_name":119,"show_sort_weight":29,"slug":120},"World Cup","world-cup",{"id":122,"doc_module":4,"doc_module_name":46,"category_name":123,"show_sort_weight":122,"slug":124},10,"Lifestyle","lifestyle",{"id":126,"doc_module":4,"doc_module_name":46,"category_name":127,"show_sort_weight":98,"slug":128},19,"General","general"]