Serum PTH, vitamin D, and calcium levels in patients with medication-related osteonecrosis of the jaw: A case-control study

BACKGROUND: To determine serum parathyroid hormone (PTH), vitamin D, and calcium levels in patients with medication related osteonecrosis of the jaw (MRONJ), compared with patients receiving similar medication but without MRONJ; also, to analyze the relation between MRONJ and inadequate vitamin D and calcium supplements. METHODS: This retrospective case control study included patients diagnosed with MRONJ and a control group of patients receiving similar medication for the same pathologies who did not present MRONJ. Participants were divided into two groups: MRONJ cases and control group subjects. Peripheral blood samples were obtained to determine serum PTH, vitamin D, and calcium levels. Data were recorded from medical histories and in clinical interviews. RESULTS: Eighty five patients were included: 25 MRONJ cases and 60 control patients. Significant differences were not found between groups for serum PTH, vitamin D values and calcium levels. Adequate vitamin D and calcium supplementation was observed more frequently among controls compared with cases; however, this difference did not reach statistical significance. CONCLUSION: The variations in PTH, calcium, and vitamin D serum levels do not appear to play a significant role in the pathophysiology MRONJ. However, monitoring these biochemical parameters could be important for the management of patients on antiresorptive drugs, as alterations may affect bone metabolism and overall health.