Antiangiogenic Medications Impede the Oral Mucosal Microcirculation and Interfere with Oral Wound Healing: A Complication Deserving of Attention

ABSTRACT Long‐term antiangiogenic therapy may be linked to medication‐related osteonecrosis of the jaw (MRONJ), complicating surgical treatment due to impaired postoperative wound healing. However, the mechanisms underlying these healing difficulties remain unclear. This bidirectional cohort study e...

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Main Authors: Hongyuan Huang, Ning Zhao, Jianhua Zhu, Qingxiang Li, Qiao Qiao, Yuanning Yang, Ying Zhou, Chuanbin Guo, Yuxing Guo
Format: Article
Language:English
Published: Wiley 2025-07-01
Series:MedComm
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Online Access:https://doi.org/10.1002/mco2.70279
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author Hongyuan Huang
Ning Zhao
Jianhua Zhu
Qingxiang Li
Qiao Qiao
Yuanning Yang
Ying Zhou
Chuanbin Guo
Yuxing Guo
author_facet Hongyuan Huang
Ning Zhao
Jianhua Zhu
Qingxiang Li
Qiao Qiao
Yuanning Yang
Ying Zhou
Chuanbin Guo
Yuxing Guo
author_sort Hongyuan Huang
collection DOAJ
description ABSTRACT Long‐term antiangiogenic therapy may be linked to medication‐related osteonecrosis of the jaw (MRONJ), complicating surgical treatment due to impaired postoperative wound healing. However, the mechanisms underlying these healing difficulties remain unclear. This bidirectional cohort study explored the impact of antiangiogenic medications (AGM) in combination with antiresorptive medications (ARM) on oral mucosal microcirculation and its relationship with surgical outcomes in MRONJ patients. A total of 30 patients (15 using ARM and 15 using both ARM and AGM) and 15 healthy volunteers undergoing surgery were included. A handheld vital microscope (HVM) was utilized to assess oral mucosal microcirculation. The results showed that patients taking both AGM and ARM had reduced microvascular density and more stagnant microcirculation than patients taking ARM alone and healthy volunteers. Additionally, impaired microcirculation was also statistically linked to poorer surgical prognosis in MRONJ patients receiving AGM&ARM with lower microcirculation parameters. This study highlights the potential adverse effect of AGM on oral mucosal microcirculation, contributing to impaired wound healing after surgery in MRONJ patients. This study provides new evidence for the vascular mechanisms involved in healing difficulties in MRONJ and supports the hypothesis that AGM plays a detrimental role in oral surgical recovery.
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spelling doaj-art-b99a8cecf8e147b8bac122e9b2306db32025-08-20T03:27:51ZengWileyMedComm2688-26632025-07-0167n/an/a10.1002/mco2.70279Antiangiogenic Medications Impede the Oral Mucosal Microcirculation and Interfere with Oral Wound Healing: A Complication Deserving of AttentionHongyuan Huang0Ning Zhao1Jianhua Zhu2Qingxiang Li3Qiao Qiao4Yuanning Yang5Ying Zhou6Chuanbin Guo7Yuxing Guo8Department of Oral and Maxillofacial Surgery Peking University School and Hospital of Stomatology Beijing PR ChinaDepartment of Oral and Maxillofacial Surgery Peking University School and Hospital of Stomatology Beijing PR ChinaDepartment of Oral and Maxillofacial Surgery Peking University School and Hospital of Stomatology Beijing PR ChinaDepartment of Oral and Maxillofacial Surgery Peking University School and Hospital of Stomatology Beijing PR ChinaDepartment of Oral and Maxillofacial Surgery Peking University School and Hospital of Stomatology Beijing PR ChinaDepartment of Oral and Maxillofacial Surgery Peking University School and Hospital of Stomatology Beijing PR ChinaDepartment of Oral and Maxillofacial Surgery Peking University School and Hospital of Stomatology Beijing PR ChinaDepartment of Oral and Maxillofacial Surgery Peking University School and Hospital of Stomatology Beijing PR ChinaDepartment of Oral and Maxillofacial Surgery Peking University School and Hospital of Stomatology Beijing PR ChinaABSTRACT Long‐term antiangiogenic therapy may be linked to medication‐related osteonecrosis of the jaw (MRONJ), complicating surgical treatment due to impaired postoperative wound healing. However, the mechanisms underlying these healing difficulties remain unclear. This bidirectional cohort study explored the impact of antiangiogenic medications (AGM) in combination with antiresorptive medications (ARM) on oral mucosal microcirculation and its relationship with surgical outcomes in MRONJ patients. A total of 30 patients (15 using ARM and 15 using both ARM and AGM) and 15 healthy volunteers undergoing surgery were included. A handheld vital microscope (HVM) was utilized to assess oral mucosal microcirculation. The results showed that patients taking both AGM and ARM had reduced microvascular density and more stagnant microcirculation than patients taking ARM alone and healthy volunteers. Additionally, impaired microcirculation was also statistically linked to poorer surgical prognosis in MRONJ patients receiving AGM&ARM with lower microcirculation parameters. This study highlights the potential adverse effect of AGM on oral mucosal microcirculation, contributing to impaired wound healing after surgery in MRONJ patients. This study provides new evidence for the vascular mechanisms involved in healing difficulties in MRONJ and supports the hypothesis that AGM plays a detrimental role in oral surgical recovery.https://doi.org/10.1002/mco2.70279hand‐held vital microscopemedication‐related osteonecrosis of the jawmicrocirculationwound healing
spellingShingle Hongyuan Huang
Ning Zhao
Jianhua Zhu
Qingxiang Li
Qiao Qiao
Yuanning Yang
Ying Zhou
Chuanbin Guo
Yuxing Guo
Antiangiogenic Medications Impede the Oral Mucosal Microcirculation and Interfere with Oral Wound Healing: A Complication Deserving of Attention
MedComm
hand‐held vital microscope
medication‐related osteonecrosis of the jaw
microcirculation
wound healing
title Antiangiogenic Medications Impede the Oral Mucosal Microcirculation and Interfere with Oral Wound Healing: A Complication Deserving of Attention
title_full Antiangiogenic Medications Impede the Oral Mucosal Microcirculation and Interfere with Oral Wound Healing: A Complication Deserving of Attention
title_fullStr Antiangiogenic Medications Impede the Oral Mucosal Microcirculation and Interfere with Oral Wound Healing: A Complication Deserving of Attention
title_full_unstemmed Antiangiogenic Medications Impede the Oral Mucosal Microcirculation and Interfere with Oral Wound Healing: A Complication Deserving of Attention
title_short Antiangiogenic Medications Impede the Oral Mucosal Microcirculation and Interfere with Oral Wound Healing: A Complication Deserving of Attention
title_sort antiangiogenic medications impede the oral mucosal microcirculation and interfere with oral wound healing a complication deserving of attention
topic hand‐held vital microscope
medication‐related osteonecrosis of the jaw
microcirculation
wound healing
url https://doi.org/10.1002/mco2.70279
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