A multicenter prospective study of the treatment for medication-related osteonecrosis of the jaw and a pathological analysis

2020 Fiscal Year Final Research Report

• Project/Area Number: 17K17283
• Research Category: Grant-in-Aid for Young Scientists (B)
• Allocation Type: Multi-year Fund
• Research Field: Surgical dentistry
• Research Institution: Nagasaki University
• Principal Investigator: HAYASHIDA Saki 長崎大学, 病院(歯学系), 助教 (40644050)
• Project Period (FY): 2017-04-01 – 2021-03-31
• Keywords: 薬剤関連顎骨壊死 / 外科療法 / 休薬の意義

Outline of Final Research Achievements

Medication-related osteonecrosis of the jaw (MRONJ) causes a decrease in the patient's quality of life and interferes with the treatment of the disease. Its pathophysiology and pathogenic mechanism have not been elucidated and standard treatment has not been established.
Therefore, this study searched for clinical factors related to MRONJ. In a multicenter study, statistical analysis of 361 cases identified the treatment method and primary disease, malignant tumor vs. osteoporosis, as the largest factors related to the treatment prognosis. As for the treatment method, the healing rate was better in the surgical treatment than in the conservative treatment. As a result of increasing the number of cases to 427 cases, the superiority of surgical treatment was shown. In addition, regarding the drug holiday during the treatment of MRONJ, there was no significant difference in the drug holiday regardless of the underlying disease when surgical treatment was performed.

Free Research Field

口腔外科

Academic Significance and Societal Importance of the Research Achievements

骨粗鬆症や悪性腫瘍の骨転移の治療薬である骨吸収抑制薬の有害事象に薬剤関連顎骨壊死がある。薬剤関連顎骨壊死は持続する炎症症状により経口摂取量の減少や不眠など患者の日常生活において支障を及ぼし、QOL（生活の質）の低下を招く。また、急性炎症により原疾患の治療の延期や中断を余儀なくされることもある。
本研究は薬剤関連顎骨壊死の治療法に関して外科療法の有効性を示すと同時に、原疾患治療薬である骨吸収抑制薬の休薬の意義についても検討した。これにより骨粗鬆症患者や悪性腫瘍患者のQOLを維持する一助となる可能性を示唆した。