Factors Influencing Severity of Medication-Related Osteonecrosis of the Jaw: A Retrospective Study

Purpose: The progression of medication-related osteonecrosis of the jaw (MRONJ) is influenced by many factors. This study aimed to identify the clinical risk factors associated with severe MRONJ (stage 3). Patients and Methods: The data of patients with MRONJ who were hospitalized between July 2013 and December 2019 were retrospectively analyzed. Demographic and clinical factors were the independent variables, and the clinical stage of MRONJ lesions was the dependent variable. Multivariate logistic regression analysis was performed to identify the risk factors for advanced stage disease (MRONJ stage 3). Results: A total of 79 patients (with 93 MRONJ lesions) were included. In multivariate regression anal- ysis, the risk factors associated with stage 3 MRONJ were age <= 6 years (odds ratio [OR] = 3.968, 95% con- fidence interval [CI]: 1.280-12.301; P = .017); chemotherapy (OR = 3.687, 95% CI: 1.048-12.972; P = .042); preoperative MRONJ >= 12 duration months (OR = 7.616, 95% CI: 1.865-31.110; P = .005); lesion location in maxilla (OR = 1.150, 95% CI: 1.006-1.315; P = .041); lesion location in posterior jaw, that is, in molar area (OR = 1.384, 95% CI; 1.118-1.715; P = .003); and serum albumin <40 g/L (OR = 6.257, 95% CI: 1.313-29.815; P = .021). Conclusions: Age <= 60 years, chemotherapy, preoperative MRONJ duration >= 12 months, lesion location in maxilla, lesion location in the molar area, and serum albumin <40 g/L may increase the risk for severe MRONJ. (C) 2021 American Association of Oral and Maxillofacial Surgeons