Clinical significance of periosteal reaction as a predictive factor for treatment outcome of medication-related osteonecrosis of the jaw.

Abstract

Regarding treatment strategies for medication-related osteonecrosis of the jaw (MRONJ), surgical therapy has recently been reported to be more effective than conservative therapy. However, some patients did not achieve complete healing, even when extensive surgery was performed. Periosteal reaction in MRONJ patients is often observed by the CT examination. Tssshe purpose of this study was to investigate the relationship between periosteal reaction and treatment outcome of MRONJ. A total of 164 surgeries in 136 patients with MRONJ at two hospitals were included in the study. Correlations between various clinical and radiographic factors and treatment outcome were examined with Cox regression analysis. The results showed that the presence of periosteal reaction, as well as primary disease involving malignant tumor, were independent risk factors related to poor outcome. Furthermore, we examined factors related to the occurrence of the periosteal reaction and found that 4 variables were significantly correlated with periosteal reaction by multivariate analysis: gender (female), site (lower jaw), primary disease (malignant tumor), and osteosclerosis (severe). The present study clarified that the cure rate after surgical treatment decreased in cases with periosteal reaction, suggesting that it is necessary to review the treatment method.

• Authors: Yuka Kojima, Yumi Kawaoka, Shunsuke Sawada, Saki Hayashida, Kohei Okuyama, Hirokazu Yutori, Akiko Kawakita, Suguru Ishida, Sakiko Soutome, Souichi Yanamoto, Masahiro Umeda, Hiroshi Iwai
• Journal: Journal of bone and mineral metabolism (J Bone Miner Metab) Vol. 37 Issue 5 Pg. 913-919 (Sep 2019) ISSN: 1435-5604 [Electronic] Japan
• PMID: 30830278 (Publication Type: Journal Article)

Topics

• Aged
• Aged, 80 and over
• Bisphosphonate-Associated Osteonecrosis of the Jaw (diagnostic imaging, drug therapy)
• Female
• Humans
• Male
• Periosteum (pathology)
• Risk Factors
• Tomography, X-Ray Computed
• Treatment Outcome