Evidence map›Paper›PMID 40126604›Full record

SynthesisOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2025

Prognostic indicators in medication-related osteonecrosis of the jaw: A systematic review and meta-analysis.

Ling-Ying Wei, Ching-Ming Chiu, Sang-Heng Kok, Hung-Ying Lin, Wei-Yih Chiu, Chih-Wei Yang, Jang-Jaer Lee

Abstract readSystematic ReviewMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Ling-Ying WeiDepartment of Dentistry, School of Dentistry, College of Medicine, National Taiwan University, No. 1, Chang-De Street, Taipei, 10048, Taiwan.
Ching-Ming ChiuDivision of Family Medicine, Department of Medicine, Cancer Center Branch, National Taiwan University Hospital, Taipei, Taiwan.
Sang-Heng KokDepartment of Dentistry, School of Dentistry, College of Medicine, National Taiwan University, No. 1, Chang-De Street, Taipei, 10048, Taiwan.
Hung-Ying LinDepartment of Dentistry, School of Dentistry, College of Medicine, National Taiwan University, No. 1, Chang-De Street, Taipei, 10048, Taiwan.
Wei-Yih ChiuDivision of Endocrinology and Metabolism, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Chih-Wei Yang *Graduate Institute of Medical Education and Bioethics, College of Medicine, National Taiwan University, Taipei, Taiwan.
Jang-Jaer Lee *Department of Dentistry, School of Dentistry, College of Medicine, National Taiwan University, No. 1, Chang-De Street, Taipei, 10048, Taiwan. leejj@ntuh.gov.tw.ORCID http://orcid.org/0000-0003-0964-0840

Funding

National Science and Technology Council 109-2314-B-002-036-MY3National Science and Technology Council 111-2314-B-002-063
6 · The paper itself

Abstract

Modulation of bone turnover by antiresorptive agents impairs wound healing of jaw bones, and can result in an adverse event termed medication-related osteonecrosis of the jaw (MRONJ). In recent years, the prevalence, risk factors, and prevention strategies for MRONJ have been extensively investigated, but only few studies have focused on its treatment outcome, and the proposed prognostic factors have varied greatly. We systematically reviewed the prognostic factors in patients undergoing treatment for MRONJ. In total, 33 studies met the inclusion criteria out of 1,388 screened citations. For analysis, we grouped the prognostic factors into five categories as follows: medication-related, underlying conditions, lesion-related, serum markers, and treatment modalities. Discontinuation of antiresorptive therapy was a medication-related factor significantly associated with better treatment outcomes. Regarding underlying conditions, malignancy, especially multiple myeloma, was associated with worse treatment outcomes. Among lesion-related factors, better treatment outcome was noted for maxillary lesions and lesions with sequestrum formation. By contrast, lesions of advanced stages and those with periosteal reaction had poor treatment outcomes. Regarding treatment modality, surgical therapy was associated with a better chance of healing. Results of our meta-analysis helped identify prognostic indicators of MRONJ and will assist in decision-making in the clinical setting. Based on our results, surgeons may have a better cognitive context to discuss treatment options with patients. Additionally, our findings provide convincing evidence for physicians to consider postponing antiresorptive therapy in patients with MRONJ lesions.

Indexed as

Bisphosphonate-Associated Osteonecrosis of the JawBone Density Conservation AgentsBiomarkersHumansPrognosisRisk FactorsBiomarkersBone Density Conservation AgentsAntiresorptive therapyMedication-related osteonecrosis of the jawsPrognostic indicatorTreatment outcome

Identifiers

PMID40126604

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.