Clinical Study of Anti-resorptive Agents-related Osteonecrosis of the Jaw in Patients with Osteoporosis

Abstract

Objective：This study evaluated clinical conditions, methods and results of treatment for anti-resorptive agents-related osteonecrosis of the jaw （ARONJ） in patients with osteoporosis.
Patients and Methods：Among 62 patients diagnosed with ARONJ in our clinic during the period from January 2012 to December 2016, 32 patients with osteoporosis who were receiving bisphosphonate or denosumab were enrolled in this study. Stage classification at the time of the first visit, cause of onset, methods, and results of treatment were examined in the enrolled patients. Stage classification was divided into four groups of stage 0 to 3. Treatment and outcome were assessed for each stage.
Results：Eight （25％） patients had ARONJ stage 1, 16 （50％） had stage 2, and 8 （25％） had stage 3. Stage 1 patients received conservative therapy: 50％ demonstrated success; moreover, 100％ of surgically treated patients demonstrated success. Stage 2 patients received conservative therapy: 33.3％ demonstrated success; moreover, 75％ of surgically treated patients demonstrated success. Stage 3 patients, who received conservative therapy, demonstrated failure. 100％ of stage 3 patients demonstrated success after undergoing surgery.
Conclusion：Surgical treatment is useful for ARONJ in patients with osteoporosis for whom conservative therapy was not successful.