Oral Health-Related Quality of Life and Mental Health Impairment in Patients Affected by Medication-Related Osteonecrosis of the Jaws: A Case–Control Pilot Study

In the present case–control study, the impact of medication-related osteonecrosis of the jaws (MRONJ) on patients’ oral health-related quality of life (OHRQoL), overall quality of life (QoL), and psychological status was evaluated using a set of questionnaires. These questionnaires included the Oral Health Impact Profile-14 (OHIP-14), the Short Form 36 Health Survey Questionnaire (SF-36), and the hospital anxiety and depression scale (HADS). A total of 25 MRONJ patients and 25 controls were included in the study. The results showed that MRONJ patients had a significantly poorer OHRQoL (OHIP-14 score p-value: 0.003) and lower general QoL, particularly in the domains of “physical functioning”, “physical role”, “body pain”, “general health”, and “vitality” in the SF-36 questionnaire (p-values: 0.001, 0.001, 0.013, 0.001, and 0.020). Although there were no significant differences between the groups in the SF-36 domains of “social functioning”, “emotional role”, and “mental health”, the mean sub-scores of the HADS, specifically the depression and anxiety scores (HADS-D and HADS-A), were significantly higher in MRONJ patients (p-values: 0.002 and 0.009). However, the “mental health” domain of the SF-36 questionnaire showed a correlation with both HADS-A and HADS-D scores (p-values: 0.003 and 0.031). Therefore, a comprehensive clinical examination of MRONJ patients should include the assessment of OHRQoL, overall QoL, and psychological profile using different questionnaires. This approach aims to gather detailed information about patients’ physical and psychological well-being, enabling the development of tailored treatments.

[1]  M. Dolci,et al.  Potential Relationship between Poor Oral Hygiene and MRONJ: An Observational Retrospective Study , 2023, International journal of environmental research and public health.

[2]  M. Schmitter,et al.  Oral-Health-Related Quality of Life in Patients with Medication-Related Osteonecrosis of the Jaw: A Prospective Clinical Study , 2022, International journal of environmental research and public health.

[3]  M. Aria,et al.  The use of self‐report questionnaires in an analysis of the multidimensional aspects of pain and a correlation with the psychological profile and quality of life in patients with burning mouth syndrome: A case‐control study , 2022, Journal of oral rehabilitation.

[4]  S. Jalili,et al.  A Comprehensive Evaluation of Health-Related Life Quality Assessment Through Head and Neck, Prostate, Breast, Lung, and Skin Cancer in Adults , 2022, Frontiers in Public Health.

[5]  E. Carlson,et al.  American Association of Oral and Maxillofacial Surgeons' Position Paper on Medication-Related Osteonecrosis of the Jaw-2022 Update. , 2022, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[6]  F. Saad,et al.  Experience with denosumab (XGEVA®) for prevention of skeletal-related events in the 10 years after approval , 2022, Journal of bone oncology.

[7]  D. Lam,et al.  Surgical Therapy in Patients With Medication-Related Osteonecrosis of the Jaw Is Associated With Disease Resolution and Improved Quality of Life: A Prospective Cohort Study. , 2022, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[8]  D. Lam,et al.  Development and evaluation of the clinimetric properties of the Medication-Related Osteonecrosis of the Jaw Quality of Life Questionnaire (MRONJ-QoL). , 2021, International journal of oral and maxillofacial surgery.

[9]  D. Kim,et al.  Medication Related Osteonecrosis of the Jaw: 2021 Position Statement of the Korean Society for Bone and Mineral Research and the Korean Association of Oral and Maxillofacial Surgeons , 2021, Journal of bone metabolism.

[10]  M. John,et al.  Including the patient’s oral health perspective in evidence-based decision-making , 2021, Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz.

[11]  L. Sassi,et al.  Quality of life in cancer patients with or without medication-related osteonecrosis of the jaw , 2021, Supportive Care in Cancer.

[12]  J. Braithwaite,et al.  Patient‐reported outcome measures (PROMs): A review of generic and condition‐specific measures and a discussion of trends and issues , 2021, Health expectations : an international journal of public participation in health care and health policy.

[13]  F. Giovacchini,et al.  Quality of life in patients affected by medication-related osteonecrosis of the jaws: A systematic review. , 2021, Oral surgery, oral medicine, oral pathology and oral radiology.

[14]  L. Francetti,et al.  Treatment of medication-related osteonecrosis of the jaw (MRONJ). A systematic review. , 2021, European review for medical and pharmacological sciences.

[15]  M. John,et al.  Nonmalignant Oral Disease--Specific Dental Patient-Reported Outcome Measures for Adult Patients: A Systematic Review. , 2021, The journal of evidence-based dental practice.

[16]  G. Lodi,et al.  Conservative Management of Medication-Related Osteonecrosis of the Jaws (MRONJ): A Retrospective Cohort Study , 2021, Antibiotics.

[17]  J. Yates,et al.  A systematic review of metastatic cancer presenting in osteonecrosis of the jaws (MC-ONJ) in patients undergoing antiresorptive and/or antiangiogenic therapy for skeletal-related adverse events. , 2021, Oral surgery, oral medicine, oral pathology and oral radiology.

[18]  P. Vescovi,et al.  Psychological profile and unexpected pain in oral lichen planus: a case-control multicenter SIPMO study. , 2021, Oral diseases.

[19]  M. Aria,et al.  The health-related quality of life and psychological profile in patients with oropharyngeal Pemphigus Vulgaris in complete clinical remission: a case-control study. , 2020, Journal of oral pathology & medicine : official publication of the International Association of Oral Pathologists and the American Academy of Oral Pathology.

[20]  T. Ettl,et al.  Patients’ quality of life improves after surgical intervention of stage III medication-related osteonecrosis of the jaw , 2020, Oral and Maxillofacial Surgery.

[21]  A. Antonelli,et al.  Medication-Related Osteonecrosis of the Jaw with Spontaneous Hemimaxilla Exfoliation: Report of a Case in Metastatic Renal Cancer Patient under Multidrug Therapy , 2020, Case reports in medicine.

[22]  A. Antonelli,et al.  Usefulness of advanced-platelet rich fibrin (A-PRF) and injectable-platelet rich fibrin (i-PRF) in the management of a massive medication-related osteonecrosis of the jaw (MRONJ): A 5-years follow-up case report , 2020, Indian journal of dental research : official publication of Indian Society for Dental Research.

[23]  Verônica-Caroline-Brito Reia,et al.  The impact of medication-related osteonecrosis of the jaws on the quality of life in cancer patients , 2020, Journal of clinical and experimental dentistry.

[24]  P. Vescovi,et al.  Medication-Related Osteonecrosis of Jaws (MRONJ) Prevention and Diagnosis: Italian Consensus Update 2020 , 2020, International journal of environmental research and public health.

[25]  A. Antonelli,et al.  Can Surgical Management Improve Resolution of Medication-Related Osteonecrosis of the Jaw at Early Stages? A Prospective Cohort Study. , 2020, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[26]  Megumi Kishimoto,et al.  Which symptoms negatively affect the oral health-related quality of life in patients with osteonecrosis of the jaw? , 2020, Oral surgery, oral medicine, oral pathology and oral radiology.

[27]  M. Bornstein,et al.  Medication-related osteonecrosis of the jaws (MRONJ) in cancer patients treated with denosumab VS. zoledronic acid: A systematic review and meta-analysis , 2020, Medicina oral, patologia oral y cirugia bucal.

[28]  A. Polimeni,et al.  Does Medication-Related Osteonecrosis of the Jaw Influence the Quality of Life of Cancer Patients? , 2020, Biomedicines.

[29]  C. Mannion,et al.  Medication-related osteonecrosis of the jaws and quality of life: review and structured analysis. , 2020, The British journal of oral & maxillofacial surgery.

[30]  J. Ferri,et al.  Medication-related osteonecrosis of the jaw (MRONJ) stage III: Conservative and conservative surgical approaches versus an aggressive surgical intervention: A systematic review. , 2020, Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery.

[31]  J. Zamorano,et al.  Management of cardiac disease in cancer patients throughout oncological treatment: ESMO consensus recommendations. , 2020, Annals of oncology : official journal of the European Society for Medical Oncology.

[32]  M. Marques,et al.  Antimicrobial photodynamic and photobiomodulation adjuvant therapies for prevention and treatment of medication-related osteonecrosis of the jaws: case series and long-term follow-up. , 2020, Photodiagnosis and photodynamic therapy.

[33]  T. Kofod,et al.  Workshop of European Task Force on Medication Related Osteonecrosis of the Jaw.Current challenges. , 2019, Oral diseases.

[34]  N. Yarom,et al.  Medication-Related Osteonecrosis of the Jaw: MASCC/ISOO/ASCO Clinical Practice Guideline. , 2019, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[35]  Yongfang Zhao,et al.  Quality of life in postmenopausal women with osteoporosis: a systematic review and meta-analysis , 2019, Quality of Life Research.

[36]  A. Barone,et al.  Medication-Related Osteonecrosis of the Jaw: The Use of Leukocyte-Platelet-Rich Fibrin as an Adjunct in the Treatment. , 2019, The Journal of craniofacial surgery.

[37]  C. Hayes,et al.  Perceptions and attitudes of patients towards medication-related osteonecrosis of the jaw (MRONJ): a qualitative study in England , 2019, BMJ Open.

[38]  K. Kornman,et al.  Staging and grading of periodontitis: Framework and proposal of a new classification and case definition , 2018, Journal of periodontology.

[39]  A. Mannocci,et al.  Medication-related osteonecrosis of the jaws (MRONJ) and quality of life evaluation: a pilot study. , 2017, La Clinica terapeutica.

[40]  M. Kos Association of dental and periodontal status with bisphosphonate-related osteonecrosis of the jaws. A retrospective case controlled study , 2014, Archives of medical science : AMS.

[41]  Augusto Caraceni,et al.  Studies comparing Numerical Rating Scales, Verbal Rating Scales, and Visual Analogue Scales for assessment of pain intensity in adults: a systematic literature review. , 2011, Journal of pain and symptom management.

[42]  A. Giordano,et al.  [Psychometric properties of the Italian version of the reduced form of the Oral Health Impact Profile (OHIP-14)]. , 2010, Giornale italiano di medicina del lavoro ed ergonomia.

[43]  L. Assael,et al.  American Association of Oral and Maxillofacial Surgeons position paper on bisphosphonate-related osteonecrosis of the jaws--2009 update. , 2009, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[44]  S. Pocock,et al.  The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. , 2008, Journal of clinical epidemiology.

[45]  T. T. Haug,et al.  The validity of the Hospital Anxiety and Depression Scale. An updated literature review. , 2002, Journal of psychosomatic research.

[46]  G. Apolone,et al.  The Italian SF-36 Health Survey: translation, validation and norming. , 1998, Journal of clinical epidemiology.

[47]  C. Sherbourne,et al.  The MOS 36-Item Short-Form Health Survey (SF-36) , 1992 .

[48]  R. Snaith,et al.  The Hospital Anxiety And Depression Scale , 2003, Health and quality of life outcomes.

[49]  G. Trifirò,et al.  Treatment of Medication-Related Osteonecrosis of the Jaw and its Impact on a Patient’s Quality of Life: A Single-Center, 10-Year Experience from Southern Italy , 2017, Drug Safety.

[50]  G. Gazelle,et al.  Quality of life implications of bisphosphonate-associated osteonecrosis of the jaw. , 2011, The oncologist.