Incidence of medication-related osteonecrosis of the jaw and factors involved in its pathogenesis: A single-center longitudinal retrospective cohort study

Introduction: Few studies have longitudinally investigated the frequency of medication-related osteonecrosis of the jaw (MRONJ) and its association with factors involved in its pathogenesis in patients treated with anti-resorptive agents (ARAs). The authors conducted a retrospective cohort study to determine the incidence of MRONJ in ARA-treated patients at their institution and to investigate background factors related to the incidence. Materials and methods: Of 320 patients with a history of ARA administration in 2017 at our institutional hospital, 285 were included in this study. Factors affecting MRONJ onset were retrospectively examined, including patients’ sex, age, primary disease (osteoporosis or malignant disease), ARA type (bisphosphonate/denosumab/combinations of both), ARA dosage (high or low), duration of ARA administration, presence of complications such as diabetes mellitus or malignant disease, high-risk drug use, and smoking status. Results: MRONJ was diagnosed in 35 patients (12.3%). Multivariate analysis identified high-dose ARA administration as a risk factor of MRONJ onset. Conclusion: The incidence of MRONJ in this study was higher than that reported previously. High-dose ARA treatment was found as a risk factor for MRONJ development.