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

Gabor Kammerhofer1,2, Daniel Vegh2,3, Dorottya Bányai2,4

  • 1Department of Oromaxillofacial Surgery and Stomatology, Semmelweis University, 1088 Budapest, Hungary.

Journal of Clinical Medicine
|April 28, 2023
PubMed
Abstract

Insights

Hyperglycemia significantly increases the risk of medication-related osteonecrosis of the jaw (MRONJ). Uncontrolled blood glucose levels are a key factor in developing this jawbone condition, especially after dental procedures.

Area of Science:

  • Oral and Maxillofacial Surgery
  • Endocrinology
  • Oncology

Background:

  • Medication-related osteonecrosis of the jaw (MRONJ) is a serious side effect of certain cancer and osteoporosis drugs.
  • The link between hyperglycemia and MRONJ development requires further investigation.

Purpose of the Study:

  • To evaluate the association between hyperglycemia and the incidence of medication-related osteonecrosis of the jaw.
  • To identify hyperglycemia as a potential risk factor for MRONJ.

Main Methods:

  • Retrospective analysis of 260 patients from January 2019 to December 2020.
  • Inclusion of fasting glucose data to assess hyperglycemia.
  • Comparison of hyperglycemia prevalence between MRONJ and control groups.

Main Results:

  • A significant association was found between hyperglycemia and MRONJ (p = 0.003).
  • Hyperglycemia was present in approximately 40% of the MRONJ group versus 21% of the control group.
  • Hyperglycemia was identified as a more relevant risk factor than poor oral hygiene.

Conclusions:

  • Hyperglycemia-induced vascular anomalies and immune dysfunction may contribute to MRONJ development.
  • Uncontrolled plasma glucose levels significantly elevate the risk of jawbone necrosis post-intervention.
  • Ischemia, a complication of abnormal glucose metabolism, is a potential risk factor for MRONJ.
Keywords:
bisphosphonatesdiabeteshyperglycemiaoral surgeryosteonecrosis

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