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Nonexposed antiresorptive agent-related osteomyelitis of the jaw: a single-center cohort study

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Abstract

Introduction

The nonexposed variant of antiresorptive agent-related osteonecrosis of the jaw (ARONJ) presents with nonspecific clinical findings. The diagnosis of nonexposed ARONJ poses a critical challenge, and there is little evidence regarding its treatment and outcomes. This study aimed to examine the clinical outcomes in patients with nonexposed antiresorptive agent-related osteomyelitis of the jaw (AROMJ). The terms ARONJ and AROMJ were used separately in this study.

Materials and methods

We enrolled patients with nonexposed AROMJ (osteomyelitis of the jaw without bone exposure associated with antiresorptive agents) with partial reference to an existing position paper on ARONJ. The initiating event of osteomyelitis was limited to periodontitis. Based on the findings of bone scintigraphy, panoramic radiography, computed tomography, and histopathological examination, we also used the hierarchical diagnostic criteria (HDC) for osteomyelitis of the jaw.

Results

There were 58 confirmed cases of nonexposed AROMJ based on the HDC. All patients had sufficient clinical findings to be diagnosed with nonexposed AROMJ as osteomyelitis underwent extraction with bone debridement. The healing rate was 93.1% (54/58). Univariable analysis showed a strong association between the healing status and malignant disease, while multivariable analysis showed no strong association between them.

Conclusions

The present study had a relatively large sample size of patients with nonexposed AROMJ. The primary disease in patients with nonexposed AROMJ may not have a strong association with the healed status of the lesion. Based on its high healing rate, extraction with bone debridement in confirmed nonexposed AROMJ may prevent progression.

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Authors and Affiliations

  1. Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan

    Takuma Watanabe, Takeshi Yoshida, Sachi Akizuki, Shigeki Yamanaka, Kazumasa Nakao, Shizuko Fukuhara, Keita Asai & Kazuhisa Bessho

  2. Department of Biomedical Statistics and Bioinformatics, Graduate School of Medicine, Kyoto University, Kyoto, Japan

    Ryuji Uozumi

Authors
  1. Takuma Watanabe
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  2. Takeshi Yoshida
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  3. Sachi Akizuki
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  4. Shigeki Yamanaka
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  6. Shizuko Fukuhara
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Contributions

All authors contributed to the study conception and design. Material preparation, and data collection and analysis were performed by TW, TY, SA, SY, SF, KA, RU, KN, and KB. The first draft of the manuscript was written by TW, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Takuma Watanabe.

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Watanabe, T., Yoshida, T., Akizuki, S. et al. Nonexposed antiresorptive agent-related osteomyelitis of the jaw: a single-center cohort study. J Bone Miner Metab 40, 657–662 (2022). https://doi.org/10.1007/s00774-022-01329-3

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  • DOI: https://doi.org/10.1007/s00774-022-01329-3

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