PhD Scientific Days 2024

Budapest, 9-10 July 2024

Poster Session P - Conservative Medicine

Association between Hyperglycemia and Medication-Related Osteonecrosis of the Jaw (MRONJ)

Author(s)

Gabor Kammerhofer1, Daniel Vegh2, Zsolt Nemeth1
1: Department of Oromaxillofacial Surgery and Stomatology, Semmelweis University, 1088 Budapest, Hungary
2: Department of Prosthodontics, Semmelweis University, 1088 Budapest, Hungary

Text of the abstract

Aims: Medication-related osteonecrosis of the jaw (MRONJ) is a type of jawbone necrosis caused by the use of drugs for some types of cancer and osteoporosis. The current study aimed to evaluate the associations between hyperglycemia and the development of medicationrelated osteonecrosis of the jaw. One of the main goals of our research group is to improve the quality of life of patients with MRONJ and DM, and we aim to transfer knowledge through publications, studies and conventions. Method: Our research group investigated data collected between 1 January 2019 and 31 December 2020. A total of 260 patients were selected from the Inpatient Care Unit, Department of Oromaxillofacial Surgery and Stomatology, Semmelweis University. Fasting glucose data were used and included in the study. Results: Approximately 40% of the necrosis group and 21% of the control group presented with hyperglycemia. There was a significant association between hyperglycemia and MRONJ (p < 0.05, p = 0.003). Vascular anomaly and immune dysfunction caused by hyperglycemia can lead to necrosis after tooth extraction. Necrosis is more common in the mandible (75.0%) and in the case of parenteral antiresorptive treatment (intravenous Zoledronate and subcutaneous Denosumab). Hyperglycemia is a more relevant risk factor than bad oral habits (26.7%). Conclusion: Ischemia is a complication of abnormal glucose levels, a possible risk factor for necrosis development. Hence, uncontrolled or poorly regulated plasma glucose levels can significantly increase the risk of jawbone necrosis after invasive dental or oral surgical interventions. Treatment planning should involve a deeper understanding of the patient, minimally invasive procedures, intervention with antibiotic coverage, improved oral hygiene, and close patient monitoring. Funding: This research received no external funding.