Dental Status in Patients With Medication-Related Osteonecrosis of the Jaw: A Cross-Sectional Study



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Abstract

BACKGROUND: Poor oral hygiene exacerbates existing periodontal disease and dental hard tissue pathology, promotes exacerbation of chronic odontogenic infection and the formation of new foci, which can lead to tooth loss and the development of osteonecrosis foci.

AIM: To assess dental status in patients with medication-related osteonecrosis of the jaw.

METHODS: A cross-sectional study was conducted. Inclusion criteria were a confirmed diagnosis of medication-related osteonecrosis of the jaw. A total of 99 patients were examined. All patients (100%) had received bone-modifying agents (bisphosphonates and denosumab) for bone metastases from malignant neoplasms of various primary sites. Exclusion criteria were decompensated comorbid conditions and progression of the malignant neoplasm. Dental status was assessed using the caries intensity index, the Simplified Oral Hygiene Index of Greene-Vermillion, and the papillary-marginal-alveolar index. Calculations were performed using MS Excel 10 and Statistica 10. We determined the mean (M), median (Me), and standard deviation (σ). Distribution normality was assessed using skewness and kurtosis values and the Shapiro–Wilk test (W). The Mann–Whitney U test was used to compare between groups. Correlation was assessed using the Pearson correlation coefficient and Spearman's rank correlation test. Results were considered statistically significant at p ≤ 0.5.

RESULTS: The mean Simplified Oral Hygiene Index score was 2.38 ± 0.56 (Me 2.26; 2.5) (W = 0.96; p = 0.027). The mean papillary-marginal-alveolar index was 50.86 ± 17.09 (95% CI: 47.26; 54.47) (W = 0.94, p = 0.0005). In 38.2% of cases (n = 34), the index exceeded 60%. The prevalence of caries was 100%. The mean caries intensity index was 20.13 ± 5.67 (95% CI: 18.99; 21.26) (W = 0.95, p = 0.002). Complete secondary edentulism was diagnosed in 10 (10.1%) patients.

CONCLUSION: The condition of dental hard tissues and periodontal tissues has a significant impact on the development and progression of medication-related osteonecrosis of the jaw.

About the authors

Natalia G. Vinogradova

Central City Clinical Hospital No. 23; Ural State Medical University

Author for correspondence.
Email: ngvinogradova@yandex.ru
ORCID iD: 0000-0002-1065-7650
SPIN-code: 4303-5218

MD, Cand. Sci. (Medicine), Depart. of Surgical Dentistry, Otorhinolaryngology and Maxillofacial Surgery

Russian Federation, Yekaterinburg; Yekaterinburg

Marina P. Kharitonova

Ural State Medical University

Email: nocar@sosp.ru
ORCID iD: 0000-0003-0243-7989
SPIN-code: 6159-3872

MD, Dr. Sci. (Medicine), Professor, Depart. of Orthopedic Dentistry and General Dentistry

Russian Federation, Yekaterinburg

Natalia A. Uporova

Ural State Medical University

Email: ya@natalja-uporova.ru
ORCID iD: 0000-0002-0857-6341
SPIN-code: 1917-4660

MD, Cand. Sci. (Medicine), Depart. of Therapeutic Dentistry and Propaedeutics of Dental Diseases

Russian Federation, Yekaterinburg

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