MRONJ Linked to Higher Risk of Acute Periapical Abscesses: Study

A new large-scale study published in the American Journal of Dentistry found that patients with medication-related osteonecrosis of the jaw face an increased risk of acute periapical abscesses (PAs). Therefore regular dental visits and improved oral hygiene are essential for early diagnosis and management of dental pathology in this population.

This research examined electronic health data from 1,799,122 patients who visited a major U.S. medical facility. Using diagnostic codes, they identified cases of MRONJ and acute PAs, and then conducted statistical analyses to determine the likelihood of MRONJ occurring in patients presenting with these dental infections. Odds ratios (ORs) were calculated, with adjustments made for co-morbidities such as diabetes and smoking.

The study revealed that patients suffering from acute periapical abscesses were far more likely to also develop MRONJ when compared to the broader hospital population. Overall, patients taking any type of bisphosphonate which are commonly prescribed to strengthen bones, were over 6-times more likely (OR 6.21, P<0.0001) to develop MRONJ when presenting with a PA.

Among specific medications, alendronate users showed a particularly strong association, with a more than five-fold increased risk (OR 5.33, P=0.0001). After controlling for diabetes, the odds remained significantly elevated at OR 5.33, while adjusting for smoking still yielded a strong association of OR 4.44. Both findings remained statistically significant.