Clinical and molecular biological research to establish prophylaxis of medication-related osteonecrosis of the jaw

2020 Fiscal Year Final Research Report

• Project/Area Number: 18K17291
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 57080:Social dentistry-related
• Research Institution: Kyushu Dental College
• Principal Investigator: Funahara Madoka 九州歯科大学, 歯学部, 講師 (60796811)
• Project Period (FY): 2018-04-01 – 2021-03-31
• Keywords: 顎骨壊死 / 骨吸収抑制薬 / ビスフォスフォネート製剤 / リスク因子

Outline of Final Research Achievements

No preventive method has been established for medication-related osteonecrosis of the jaw (MRONJ). Tooth extraction has been avoided so far because it often develops after tooth extraction, but by preserving the tooth that is the source of infection, MRONJ may develop from local infection. This study was conducted to establish a method for preventing the onset of MRONJ, and the following results were obtained. 1)A multicenter retrospective study examined risk factors for developing MRONJ in 361 patients receiving high-dose bone modifiers (BMA). For patients receiving high-dose BMA, it is recommended to actively extract teeth if they have potential sources of infection. 2)A histological search of the excised mandible was performed in patients who had been treated with BMA. It was revealed that the osteoclast morphology did not recover normally when the drug was withdrawn for less than 6 months.

Free Research Field

社会系歯学

Academic Significance and Societal Importance of the Research Achievements

高用量BMAが投与されているがん患者は年々増加傾向にあり、それにつれてMRONJ発症例も増加している。MRONJは難治性で患者のQOLを著しく低下させる。これまで抜歯を避ける、抜歯を行う場合はBMAを休薬するなどの対策が一般に取られてきたが、それにもかかわらずNRONJ発症例は増加しており、有効な予防策の確立が望まれている。今回得られた結果はMRONJの発症予防法を確立するための基礎データとして大いに役立つものであり、近い将来MRONJの発症を抑制することにつながるものとして学術的にも社会的にも意義は大きいものと考えられる。