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A 5-year retrospective cohort study of denosumab induced medication related osteonecrosis of the jaw in osteoporosis patients

 Seoyeon Jung  ;  Jaeyeon Kim  ;  Jin Hoo Park  ;  Ki-Yeol Kim  ;  Hyung Jun Kim  ;  Wonse Park 
 SCIENTIFIC REPORTS, Vol.12(1) : 8641, 2022-05 
Journal Title
Issue Date
Bisphosphonate-Associated Osteonecrosis of the Jaw ; Bone Density Conservation Agents / adverse effects ; Denosumab* / adverse effects ; Diphosphonates / adverse effects ; Humans ; Osteonecrosis* / chemically induced ; Osteoporosis* / drug therapy ; Retrospective Studies
Denosumab has been suggested as a first-line therapy for osteoporotic patients. However, a standardized protocol for the prevention of denosumab induced medication-related osteonecrosis of the jaw (MRONJ) has not yet been established. The purpose of this study was to report denosumab induced MRONJ cases, and investigate the factors affecting the occurrence of MRONJ in patients who underwent denosumab and invasive dental treatment (especially tooth extraction) between October 2016 and March 2020. Four of the 98 patients developed MRONJ before and after tooth extraction. The participants were divided into two groups: receiving only denosumab (n = 51) and receiving bisphosphonate as first treatment and denosumab as second treatment (n = 47). There was no significant difference between groups in the occurrence of MRONJ and factors affecting MRONJ. Two out of 4 patients developed MRONJ regardless of invasive treatment after denosumab administration and proceeded with extraction; one patient developed MRONJ after denosumab administration and extraction. The other patient underwent a tooth extraction without osteoporosis treatment, and non-identified MRONJ developed after denosumab administration. MRONJ cases reported in this study show that MRONJ can develop as chronic inflammation without invasive dental treatment; therefore, implementing preventive dental treatment before initiating denosumab treatment is necessary to reduce the occurrence of MRONJ.
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2. College of Dentistry (치과대학) > Dept. of Advanced General Dentistry (통합치의학과) > 1. Journal Papers
2. College of Dentistry (치과대학) > Dept. of Oral and Maxillofacial Surgery (구강악안면외과학교실) > 1. Journal Papers
2. College of Dentistry (치과대학) > Others (기타) > 1. Journal Papers
Yonsei Authors
Kim, Ki Yeol(김기열) ORCID logo https://orcid.org/0000-0001-5357-1067
Kim, Hyung Jun(김형준) ORCID logo https://orcid.org/0000-0001-8247-4004
Park, Wonse(박원서) ORCID logo https://orcid.org/0000-0002-2081-1156
Park, Jin Hoo(박진후) ORCID logo https://orcid.org/0000-0003-2337-9554
Jung, Seoyeon(정서연)
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