A Multi-Center Observation Study on Medication-Related Osteonecrosis of the Jaw (MRONJ) in Patients with Osteoporosis, and Other Non-Malignant Bone Diseases, in Northwestern Italy over 16 Years
Dora Karimi,
Paolo Giacomo Arduino,
Alessio Gambino,
Francesco Erovigni,
Alessandro Dell’Acqua,
Francesco Pera,
Massimo Carossa,
Monica Pentenero,
Paolo Appendino,
Francesco Della Ferrera,
Antonella Fasciolo,
Majlinda Caka,
Mario Migliario,
Matteo Brucoli,
Stefano Franchi,
Alessandro Pezzimenti,
Vittorio Fusco
Affiliations
Dora Karimi
Department of Surgical Sciences, Cir-Dental School, University of Turin, 10126 Turin, Italy
Paolo Giacomo Arduino
Department of Surgical Sciences, Cir-Dental School, University of Turin, 10126 Turin, Italy
Alessio Gambino
Department of Surgical Sciences, Cir-Dental School, University of Turin, 10126 Turin, Italy
Francesco Erovigni
Department of Surgical Sciences, Cir-Dental School, University of Turin, 10126 Turin, Italy
Alessandro Dell’Acqua
Department of Surgical Sciences, Cir-Dental School, University of Turin, 10126 Turin, Italy
Francesco Pera
Department of Surgical Sciences, Cir-Dental School, University of Turin, 10126 Turin, Italy
Massimo Carossa
Department of Surgical Sciences, Cir-Dental School, University of Turin, 10126 Turin, Italy
Monica Pentenero
Oral Medicine and Oral Oncology Unit, Department of Oncology, San Luigi Gonzaga Hospital, University of Turin, 10043 Turin, Italy
Paolo Appendino
Department of Dentistry and Oral Surgery, Mauriziano Hospital, 10128 Turin, Italy
Francesco Della Ferrera
Department of Dentistry and Oral Surgery, Mauriziano Hospital, 10128 Turin, Italy
Antonella Fasciolo
Maxillofacial Surgery Unit, Azienda Ospedaliera Universitaria “SS Antonio e Biagio e C. Arrigo”, 15121 Alessandria, Italy
Majlinda Caka
Maxillofacial Surgery Unit, Asti Hospital, 14100 Asti, Italy
Mario Migliario
Dental Clinic, Department of Health Science, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy
Objectives: To assess the number of new cases of Medication-Related Osteonecrosis of the Jaw (MRONJ) among patients with osteoporosis and other non-malignant bone diseases in Northwestern Italy between 2007 and 2022. Methods: MRONJ cases were collected from referral centers in a population of 4.5 million. We analysed the number of new MRONJ cases per year, type of disease, administered drugs, duration of therapy (when available), and onset time of disease. Results: We analysed 198 cases (out of 1071 total MRONJ cases); diseases included osteoporosis (87%), rheumatoid arthritis (5%), their association (4%), Paget’s disease, and other various diseases (4%). Patients received bisphosphonates alone (74%), or denosumab alone (6%), or a sequence of different drugs (20%). The number of new cases increased over five years from 2 (2003–2007) to 51 (2008–2012), 65 (2013–2017), and 79 (2018–2022), and the percentage increased from 1% to 14%, 20%, and 29% of the total cases. Conclusions: The number of new MRONJ cases per year among patients with non-malignant diseases is rapidly increasing all around the world, though underestimation cannot be excluded. In this study, we describe epidemiological and clinical characteristics of patients, and the drug most frequently involved in MRONJ cases in our region over a long period, allowing a comprehensive view of the progression of the disease. Greater collaboration among specialists is needed for correct and early diagnosis to improve measures potentially reducing disease incidence and to limit quality of life deterioration in patients with osteoporosis and other non-malignant diseases.
