Denosumab-Related Osteonecrosis of the Jaw: a five year monocentric retrospective study of Ancona General Hospital

Medication-Related Osteonecrosis of Jaws (MRONJ) represents a progressive destruction and death of bone affecting the jaws of patients treated by medications increasing the risk of disease, in the absence of a previous radiation therapy. Medications involved in the etiopathogenesis of MRONJ include antiresorptive drugs and biological agents. Its incidence and prevalence in general population are unknown and highly variable, due to the heterogeneity of available epidemiological data. MRONJ significantly affects the patient’s quality of life (QoL), therefore it is necessary to improve the knowledge of its pathogenesis and lead the decision-making process of specialists. This retrospective study described the 5-years clinical experience of a monocentric Institute regarding Denosumab-related osteonecrosis of jaws cases. The study included all MRONJ cases of oncological and osteometabolic patients administered with Denosumab diagnosed from January 2014 to December 2018 in the Department of Special and Surgical Stomatology, “Ospedali Riuniti”, Ancona General Hospital. Our data showed a higher prevalence of MRONJ in female gender, in breast cancer patients and in subject administered with concurrent chemotherapy. Furthermore, the mandible represents the most affected site, pain was the most symptom complained, and stage 2 was the most common diagnosed. Despite the efficacy of prevention measures, the reduction of long-term bisphosphonates prescription, and the introduction of Denosumab, literature data showed a substantially unchanged number of new cases/year. Thus, it is fundamental to improve the scientific research, reporting any cases of new drugs, to clarify by evidence-based medicine all the controversial aspects of MRONJ.