Relationship of preoperative serum data with MRONJ patient postoperative course – Retrospective study

The purpose of this study was to clarify prognostic factors indicating the postoperative course following surgical treatment for medication-related osteonecrosis of the jaw (MRONJ). This was a retrospective investigation of postoperative results of patients who underwent surgical treatment for MRONJ at Tohoku University Hospital. Predictor variables including preoperative serum data, i.e., leukocyte, neutrophil, lymphocyte, platelet, and monocyte counts, neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), lymphocyte to monocyte ratio (LMR), C-reactive protein (CRP), albumin, and total protein (TP), were compared. Postoperative outcomes were categorized as good or poor prognosis, and serum data for each group were compared. The study sample included 35 MRONJ patients, with 16 in the good prognosis and 19 in the poor prognosis group. In the good prognosis group, lymphocyte number and LMR were significantly higher, while NLR and PLR were significantly lower as compared with the poor prognosis group. Significant differences for LMR, NLR, and PLR were mainly due to differences in lymphocyte count, while no significant differences were seen regarding neutrophils, platelets, monocytes, CRP, TP, or albumin. In patients with poor postoperative MRONJ, preoperative findings showed a decrease in lymphocytes. The relationship of preoperative lymphocyte count with postoperative outcome following MRONJ may be useful for clarifying the pathogenesis of MRONJ.