How does medication-related osteonecrosis of the jaw (MRONJ) influence the health-related quality of life after surgery?

Abstract Background Medication-Related Osteonecrosis of the Jaw (MRONJ), an established side effect of antiresorptive and antiangiogenic medication, could sometimes require surgical intervention, such as decortication. The objectives of this retrospective patient survey study were to evaluate the ef...

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Main Authors: Oliver Bissinger, Josefa Greiser, Elisabeth Maier, Philipp Ehrmann, Tamara Kakoschke, Klaus-Dietrich Wolff, Carolin Götz
Format: Article
Language:English
Published: BMC 2025-06-01
Series:BMC Oral Health
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Online Access:https://doi.org/10.1186/s12903-025-06171-3
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author Oliver Bissinger
Josefa Greiser
Elisabeth Maier
Philipp Ehrmann
Tamara Kakoschke
Klaus-Dietrich Wolff
Carolin Götz
author_facet Oliver Bissinger
Josefa Greiser
Elisabeth Maier
Philipp Ehrmann
Tamara Kakoschke
Klaus-Dietrich Wolff
Carolin Götz
author_sort Oliver Bissinger
collection DOAJ
description Abstract Background Medication-Related Osteonecrosis of the Jaw (MRONJ), an established side effect of antiresorptive and antiangiogenic medication, could sometimes require surgical intervention, such as decortication. The objectives of this retrospective patient survey study were to evaluate the effect of surgical treated MRONJ on health-related quality of life (QoL) and to assess the awareness of the risk of MRONJ. Methods The MRONJ-related QoL in both cancer and osteoporosis patients was determined in four different time periods after surgery applying the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Core Questionnaire (QLQ-C30), a modified version of the Module for Head and Neck Cancer (H&N35) and MRONJ-specific questions. In addition the patients´ awareness of the risk of MRONJ when being prescribed the medication was examined. 65 patients with MRONJ (28 males and 37 females) who underwent surgery of the jaw were included in this study. Results In comparison to normative data of the German population cancer and osteoporosis patients showed a reduction in their QoL in general. It was demonstrated that MRONJ causes an even further negative impact, particularly on role and social function. Amongst the MRONJ patients certain factors such as female sex, breast cancer as underlying disease, hypothyroidism, denture, nicotine abuse and multiple surgeries of the MRONJ were associated with worse QoL. The majority of patients suffered from a lack of knowledge regarding the risk of MRONJ when starting antiresorptive or antiangiogenic treatment. Unaware patients manifested worse QoL results and had to undergo more operations. Conclusion QoL of MRONJ patients is deteriorated and the number of surgeries and the patients´ awareness have a significant impact on QoL. In order to reach better awareness amongst both patients, doctors and other health care professionals and to detect MRONJ at an earlier stage, the H&N35 and MRONJ specific questions should be routinely administered to osteoporosis and cancer patients when starting antiresorptive or antiangiogenic treatment.
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spelling doaj-art-11ef0656a23f405696cd773cce015c3e2025-08-20T03:47:17ZengBMCBMC Oral Health1472-68312025-06-0125111410.1186/s12903-025-06171-3How does medication-related osteonecrosis of the jaw (MRONJ) influence the health-related quality of life after surgery?Oliver Bissinger0Josefa Greiser1Elisabeth Maier2Philipp Ehrmann3Tamara Kakoschke4Klaus-Dietrich Wolff5Carolin Götz6Department of Oral and Maxillofacial Surgery, Medical University of Innsbruck, Anichstr. 35Department of Oral and Maxillofacial Surgery, School of Medicine, Technical University of Munich, Klinikum Rechts der IsarDepartment of Oral and Maxillofacial Surgery, Medical University of Innsbruck, Anichstr. 35Department of Oral and Maxillofacial Surgery, Medical University of Innsbruck, Anichstr. 35Department of Oral and Maxillofacial Surgery and Facial Plastic Surgery, University Hospital LMU Munich. Lindwurmstr. 2ADepartment of Oral and Maxillofacial Surgery, School of Medicine, Technical University of Munich, Klinikum Rechts der IsarDepartment of Oral and Maxillofacial Surgery, Medical University of Innsbruck, Anichstr. 35Abstract Background Medication-Related Osteonecrosis of the Jaw (MRONJ), an established side effect of antiresorptive and antiangiogenic medication, could sometimes require surgical intervention, such as decortication. The objectives of this retrospective patient survey study were to evaluate the effect of surgical treated MRONJ on health-related quality of life (QoL) and to assess the awareness of the risk of MRONJ. Methods The MRONJ-related QoL in both cancer and osteoporosis patients was determined in four different time periods after surgery applying the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Core Questionnaire (QLQ-C30), a modified version of the Module for Head and Neck Cancer (H&N35) and MRONJ-specific questions. In addition the patients´ awareness of the risk of MRONJ when being prescribed the medication was examined. 65 patients with MRONJ (28 males and 37 females) who underwent surgery of the jaw were included in this study. Results In comparison to normative data of the German population cancer and osteoporosis patients showed a reduction in their QoL in general. It was demonstrated that MRONJ causes an even further negative impact, particularly on role and social function. Amongst the MRONJ patients certain factors such as female sex, breast cancer as underlying disease, hypothyroidism, denture, nicotine abuse and multiple surgeries of the MRONJ were associated with worse QoL. The majority of patients suffered from a lack of knowledge regarding the risk of MRONJ when starting antiresorptive or antiangiogenic treatment. Unaware patients manifested worse QoL results and had to undergo more operations. Conclusion QoL of MRONJ patients is deteriorated and the number of surgeries and the patients´ awareness have a significant impact on QoL. In order to reach better awareness amongst both patients, doctors and other health care professionals and to detect MRONJ at an earlier stage, the H&N35 and MRONJ specific questions should be routinely administered to osteoporosis and cancer patients when starting antiresorptive or antiangiogenic treatment.https://doi.org/10.1186/s12903-025-06171-3BisphosphonatesAntiresorptive agentsAntiangiogenic agentsMRONJQuality of lifeAwareness
spellingShingle Oliver Bissinger
Josefa Greiser
Elisabeth Maier
Philipp Ehrmann
Tamara Kakoschke
Klaus-Dietrich Wolff
Carolin Götz
How does medication-related osteonecrosis of the jaw (MRONJ) influence the health-related quality of life after surgery?
BMC Oral Health
Bisphosphonates
Antiresorptive agents
Antiangiogenic agents
MRONJ
Quality of life
Awareness
title How does medication-related osteonecrosis of the jaw (MRONJ) influence the health-related quality of life after surgery?
title_full How does medication-related osteonecrosis of the jaw (MRONJ) influence the health-related quality of life after surgery?
title_fullStr How does medication-related osteonecrosis of the jaw (MRONJ) influence the health-related quality of life after surgery?
title_full_unstemmed How does medication-related osteonecrosis of the jaw (MRONJ) influence the health-related quality of life after surgery?
title_short How does medication-related osteonecrosis of the jaw (MRONJ) influence the health-related quality of life after surgery?
title_sort how does medication related osteonecrosis of the jaw mronj influence the health related quality of life after surgery
topic Bisphosphonates
Antiresorptive agents
Antiangiogenic agents
MRONJ
Quality of life
Awareness
url https://doi.org/10.1186/s12903-025-06171-3
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