title: Medication-related osteonecrosis of the jaw: a preliminary retrospective study of 130 patients with multiple myeloma.
abstract: BACKGROUND
  Multiple myeloma (MM) is characterized by a neoplastic proliferation of plasma cells primarily in the bone marrow. Bisphosphonates (BP) are used as supportive therapy in the management of MM. This study aimed to analyze the incidence, risk factors, and clinical outcomes of medication-related necrosis of the jaw (MRONJ) in MM patients.
  
  
  METHODS
  One hundred thirty MM patients who had previous dental evaluations were retrospectively reviewed. Based on several findings, we applied the staging and treatment strategies on MRONJ. We analyzed gender, age, type of BP, incidence, and local etiological factors and assessed the relationship between these factors and the clinical findings at the first oral examination.
  
  
  RESULTS
  MRONJ was found in nine male patients (6.9%). The mean patient age was 62.2 years. The median BP administration time was 19 months. Seven patients were treated with a combination of IV zoledronate and pamidronate, and two patients received single-agent therapy. The lesions were predominantly located in the mandible (n= 8), and the most common predisposing dental factor was a history of prior extraction (n= 6). Half of the MRONJ were related to diseases found on the initial dental screen. Patients with MRONJ were treated with infection control and antibiotic therapy. When comparing between the MRONJ stage and each factor (sign, location, etiologic factor, BP type, treatment, and outcome), there were no significant differences between stages, except for between the stage and sign (with or without purulence).
  
  
  CONCLUSIONS
  For prevention of MRONJ, we recommend routine dental examinations and treatment prior to starting BP therapy.
authors.affiliation: Department of Oral and Maxillofacial Surgery, College of Medicine, Soonchunhyang University Cheonan Hospital, Cheonan, Republic of Korea.
authors.forename: Woo-Sung
authors.initials: WS
authors.lastname: Choi
authors.affiliation: Department of Oral and Maxillofacial Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: Jae-Il
authors.initials: JI
authors.lastname: Lee
authors.affiliation: Department of Oral and Maxillofacial Surgery, College of Medicine, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Republic of Korea.
authors.forename: Hyun-Joong
authors.initials: HJ
authors.lastname: Yoon
authors.affiliation: Department of Hematology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: Chang-Ki
authors.initials: CK
authors.lastname: Min
authors.affiliation: Department of Dentistry, St. Paul's Hospital, College of Medicine The Catholic University of Korea, 180 Wangsan-ro, Dongdaemun-gu, Seoul 130-709 Republic of Korea.
authors.forename: Sang-Hwa
authors.initials: SH
authors.lastname: Lee
keywords: Bisphosphonate; Medication-related necrosis of the jaw; Multiple myeloma