Retrospective Study On The Prognosis Of Surgical Treatment Of MRONJ

This study aims to evaluate prognostic factors, particularly surgical approaches, in patients undergoing surgical treatment for medication-related osteonecrosis of the jaw (MRONJ). A retrospective analysis was conducted on 228 MRONJ patients treated surgically from January 2013 to January 2025. Data on demographics, clinical staging, lesion location, primary diseases, medication history, and surgical techniques were analyzed. Statistical comparisons utilized Chi-square tests for categorical variables (e.g., gender, lesion site) and Fisher’s exact tests for surgical approaches, including bone tube application in stage 2 jaw resections, drainage versus primary closure in stage 3 maxillary procedures, and titanium plate reconstruction in mandibular segmental resections. Significance was set at P < 0.05. Lesions predominantly involved the mandible (64.2%) versus maxilla (30.6%), with a mandible-to-maxilla ratio of 1.94:1. Cure rate was 82.2% (187/228) after 6-month follow-up. Mandibular lesions exhibited significantly lower cure rates than maxillary lesions (P < 0.05). Bone tube application in stage 2 jaw resections (P < 0.05) and titanium plate reconstruction in stage 3 mandibular resections (P < 0.05) improved outcomes. No significant difference was observed between drainage and primary closure for stage 3 maxillary lesions (P > 0.05). MRONJ prognosis shows no gender predilection but demonstrates poorer surgical outcomes in the mandible. Bone tube techniques enhance healing in stage 2 cases, while titanium plate reconstruction improves cure rates in advanced mandibular osteonecrosis. These findings advocate for tailored surgical strategies based on anatomical and pathological severity.