title: Medication--related osteonecrosis of the jaws. The first reported cases in the Baltic States and a literature review.
abstract: BACKGROUND
  Medication-related osteonecrosis of the jaws (MRONJ) is a severe side effect of antiresorptive or antiangiogenic therapy that manifests as an exposed bone, accompanied by clinical signs of infection, persisting for more than 8 weeks, without history of radiation therapy or metastases to the jaws. The aim of the study was to present first MRONJ cases in Lithuania and review trends in the modern research literature on the subject.
  
  
  METHODS
  We retrospectively reviewed patient charts with a diagnosis of "Inflammatory conditions of the jaws" treated in Vilnius University Hospital Žalgiris Clinic, Department of maxillofacial surgery in 2007-2014. Patients diagnosed with MRONJ were selected for the study. Demographic data, characteristics of the disease and treatment modalities were analysed.
  
  
  RESULTS
  Nine cases (five male and four female) of MRONJ were analysed. The mean patient age was 69±7,9 years. Predominant primary malignancy was prostate cancer. Osteonecrotic lesions were located both in maxilla and mandible. In all cases we started with a conservative treatment first. After the antibiotic therapy with or without sequestrectomy, the condition of all patients stabilized and improved to stage I MRONJ.
  
  
  CONCLUSIONS
  MRONJ is a disturbing condition resulting in a severely worsened quality of life in the affected patients. This is the first case series of successfully treated patients suffering from stage II or III MRONJ in the Baltic States. A more comprehensive understanding of MRONJ will hopefully allow clinicians to enhance accuracy in risk assessment and forecast positive and negative outcomes of antiresorptive or antiangiogenic therapy.
authors.affiliation: Vilnius University Hospital Žalgiris Clinic, 8, Žalgirio str. 117, Vilnius LT-08217, Lithuania. linas.zaleckas@zalgioklinika.lt.
authors.forename: Linas
authors.initials: L
authors.lastname: Zaleckas
authors.forename: Mindaugas
authors.initials: M
authors.lastname: Stacevičius
authors.forename: Dovilė
authors.initials: D
authors.lastname: Proškutė
authors.forename: Jurgita
authors.initials: J
authors.lastname: Povilaitytė
mesh_terms: D000368:Aged; D001454:Baltic States; D059266:Bisphosphonate-Associated Osteonecrosis of the Jaw; D050071:Bone Density Conservation Agents / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008097:Lithuania; D008297:Male; D008875:Middle Aged; D011788:Quality of Life
chemical_list: D050071:Bone Density Conservation Agents