ABSTRACT
Certain genetic factors, including single-nucleotide polymorphisms (SNPs) in the SIRT1 gene, have been linked to medication-related osteonecrosis of the jaw (MRONJ). This study examined four SNPs in the SIRT1 gene and implemented multivariate statistical analysis to analyze genetic and clinical factors in MRONJ patients. Genomic DNA was isolated from peripheral blood samples of 63 patients of European origin treated for MRONJ, and four SNP genotypes in the gene encoding the SIRT-1 protein were determined by Sanger sequencing. The allele frequencies measured in the MRONJ population were compared with allele frequencies measured in the European population in the National Center for Biotechnology Information Allele Frequency Aggregator (NCBI ALFA) database. Genetic and clinical factors were examined with multivariate statistical analysis. A C:A allele distribution ratio of 77.8:22.2 was measured in the rs932658 SNP. In the ALFA project, a C:A allele distribution ratio of 59.9:40.1 was detected in the European population, which was found to be a significant difference (p = 4.5 × 10-5). Multivariate statistical analysis revealed a positive correlation (0.275) between the genotype of SNP rs932658 and the number of stages improved during appropriate MRONJ therapy. It is concluded that allele A in SNP rs932658 in the SIRT1 gene acts as a protective factor in MRONJ.
Subject(s)
Osteonecrosis , Polymorphism, Single Nucleotide , Humans , Sirtuin 1/genetics , Genotype , AllelesABSTRACT
Introduction: The potential risk factors of the medication-related osteonecrosis of the jaw remain the subject of research because of the different results of the studies. Aim: In our study, we examined the potential prognostic factors of the medication-related osteonecrosis of the jaw. Method: Patients with medication-related osteonecrosis of the jaw presenting between June 2006 and November 2013 were included in this study. Prognosis was examined, based on stage improvement, healing and the rate of relapse. The minimum follow-up time was 5 years. Statistical analysis: The results were evaluated by Fisher's exact test, Mann-Whitney test, Kruskal-Wallis probe and chi-square test. The outcomes were accepted as significant when the p value was <0.05. Results: The stage stated at the first check-up indicated poor prognosis (p = 0.009). The relapse rate of patients with non-insulin-dependent diabetes mellitus was significantly higher than the relapse rate of those without diabetes mellitus (p = 0.050). Regarding the relapse rate, the relationship between patients receiving anti-estrogen therapy and those without hormonal therapy was significant (p = 0.036). The prognosis of mandibular necrosis was significantly worse (p = 0.003) than the prognosis of maxillary necrosis. We did not find significant connection between prognosis and gender, age, administration route of bisphosphonate, invasive procedures preceding the necrosis, chemotherapeutic and steroid treatment. Conclusion: Of the factors studied here, the stage stated at the first check-up, the localization of the necrotic bone parts, diabetes mellitus and anti-estrogen therapy used simultaneously with the antiresorptive therapy affected the prognosis of the medication-related osteonecrosis of the jaw. Orv Hetil. 2020; 161(8): 283-289.
Subject(s)
Bisphosphonate-Associated Osteonecrosis of the Jaw/therapy , Humans , PrognosisABSTRACT
PURPOSE: We examined the effect of the membranous form of platelet-rich fibrin (PRF) on patients with medication-related osteonecrosis of the jaw. MATERIALS AND METHODS: Our study included patients who underwent an operation because of second- or third-stage osteonecrosis of the jaw induced by antiresorptive therapy. The diagnosis of medication-related osteonecrosis of the jaw was based on the 2009 and 2014 recommendations of the American Association of Oral and Maxillofacial Surgeons. On the basis of the duration of treatment, we divided our patients into 2 groups. Patients in the first group (Gr1) underwent traditional surgical therapy between 2009 and 2014, whereas patients in the second group (Gr2) underwent PRF membrane-supplemented operations between 2015 and 2017. Outcomes were assessed based on patient recovery, stage improvement, and relapse rate. The follow-up period was a minimum of 1 year. RESULTS: Our study included 101 patients: 73 in Gr1 and 28 in Gr2. The results in Gr2 were significantly better than those in Gr1: recovery (P = .022), stage improvement (P = .005), and relapse rate (P < .001). CONCLUSIONS: In Gr2, significantly better results were achieved in terms of stage improvement, recovery, and relapse rate than in Gr1.
