Importance of Professional Oral Hygiene in Preventing Medication-related Osteonecrosis of the Jaw

抄録

It has been reported that bisphosphonate treatment induces medication-related osteonecrosis of the jaw(MRONJ). Although dental extraction, periodontal disease and systemic disease are noted as risk factors for MRONJ, there are few reports examining the relationship between oral hygiene and MRONJ. The purpose of this retrospective study was to determine risk factors for MRONJ occurrence, and to assess whether MRONJ occurrence is suppressed by professional oral hygiene management or not.

The participants were patients undergoing zoledronate treatment. Dental examination was undertaken by dentists or dental hygienists every six months during the consultation period. The participants were divided into intervention and non-intervention groups. The former underwent professional oral hygiene management by a dental hygienist every three or four weeks, whereas the latter group did not desire professional oral hygiene management.

Two participants in the intervention group(n=40)and four participants in the nonintervention group(n=11)developed MRONJ. The incidence of MRONJ was significantly reduced in the intervention group when compared with the non-intervention group(p=0.015). The onset of MRONJ in the intervention group was significantly prolonged(p=0.003). In addition, proportional hazards analysis indicated that the only significant factor in the development of MRONJ was the delivery of oral hygiene management(p<0.05), and the hazard ratio was 0.109.

It is suggested that oral hygiene management suppressed the development of MRONJ.There is a possibility that MRONJ could be suppressed by regular oral hygiene management performed by a dental hygienist.