PREVALENCE AND MANAGEMENT OF MEDICATION-RELATED OSTEONECROSIS OF THE JAW (MRONJ) IN PAKISTANI PATIENTS
Main Article Content
Keywords
Osteoporosis, Medication-related osteonecrosis of the jaw, Bisphosphonates, Denosumab.
Abstract
Background: Antiresorptive and antiangiogenic therapies may cause medication-related osteonecrosis of the jaw (MRONJ), which is a significant adverse effect.
Objective: To determine the prevalence and evaluate the current management practices of MRONJ among Pakistani patients.
Methodology: A descriptive cross-sectional study was conducted at Karachi Hospital over six months (January to June 2024). Non-probabilities 118 individuals at least 18 years old, with a history of using antiresorptive or antiangiogenic drugs, and with clinical characteristics indicative of MRONJ were recruited by easy sampling. Interviews, exams, and evaluations of medical records were used to gather information on demographics, underlying diseases, medication history, clinical staging, risk factors, and treatment strategies. SPSS v25 was used for statistical analysis, and chi-square tests were used to evaluate relationships (p < 0.05 significance).
Results: Among the patients, 48.31% were between the ages of 41 and 60, and 59.32% were female. The most prevalent underlying ailment was osteoporosis (54.24%), while the most common drug was denosumab (41.53%). The two biggest risk variables were recent dental extractions (56.78%) and poor oral hygiene (61.02%). Clinically, 27.12% had Stage 3 MRONJ and 43.22% had Stage 2 MRONJ. Surgical resection (16.95%), surgical debridement (30.51%), and conservative therapy (52.54%) were among the management techniques. Compared to conservative therapy (30.65%), surgical intervention demonstrated greater complete recovery rates (55.36%). Age (p=0.001), length of medication usage (p=0.003), tooth extraction history (p<0.001), and diabetes mellitus (p=0.046) were all significantly associated with advanced MRONJ stages.
Conclusion: MRONJ is prevalent among Pakistani patients with antiresorptive therapy, with surgical management yielding better outcomes than conservative methods.
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Dr. Syeda Bushra Inayat
Lecturer, Department of Oral Biology, Dow International Dental College, Karachi
Dr. Noor ul Fatima
Jinnah Sindh Medical University, Karachi
Dr. Misbah Abbasi
Jinnah Sindh Medical University, Karachi
Dr. Sualeha M. Qasim
Qasim Dental care sector 11-F, New Karachi, Karachi
Dr. Aqsa Wahid Ghauri
Lecturer, Anatomy Department, Dow International Dental College, Karachi
Dr. Bakhtawar Khan
Dental Care Clinic, Liaquatabad 4, Karachi