Neurosensory disturbances amongst patients diagnosed with mandibular Medication-Related Osteonecrosis of the Jaw (MRONJ)

Abstract

<p><strong>Aims:</strong> The aims of this study were to evaluate the clinical and radiological characteristics of patients diagnosed with mandibular medication-related osteonecrosis of the jaw (MRONJ) and to examine its associations with neurosensory disturbances.</p><p><strong>Methods:</strong> A retrospective review was conducted of the clinical records of all patients diagnosed with MRONJ who were seen in the Department of Oral and Maxillofacial Surgery at the Prince Philip Dental Hospital between January 2013 and August 2024.Patients diagnosed with mandibular MRONJ who had undergone cone-beam computed tomography (CBCT) or computed tomography (CT) imaging were included in the study. Clinical characteristics, including patient demographics, medical history, clinical presentation, and subsequent interventions, were recorded. The radiological manifestations of the inferior alveolar canal were also evaluated.</p><p><strong>Results:</strong> A total of 52 patients with 63 MRONJ lesions were included, of which 21 lesions exhibited neurosensory disturbances. The most common radiological manifestations of the inferior alveolar canal were osteosclerosis (95.3%) and osteolysis (54.0%). Advanced stage III MRONJ lesions (55.6%) were more likely to present with neurosensory disturbances compared to early-stage I (16.6%) and stage II (11.8%) lesions. Three patients presented with pathological fractures involving the inferior alveolar canal, and all exhibited neurosensory disturbances. Furthermore, 80% of the patients with sequestration involvement presented with neurosensory disturbances.</p><p><strong>Conclusion:</strong> In this retrospective review, approximately one-third of mandibular MRONJ lesions presented with neurosensory disturbances. The presence of pathological fractures and sequestration and advanced MRONJ stages were associated with the occurrence of neurosensory disturbances.</p>