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

Abstract

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.