AI Article Synopsis
- The study aimed to compare surgical and conservative treatment outcomes for medication-related osteonecrosis of the jaw, using various databases for literature review.
- Quality assessment found moderate evidence in some studies, with varying levels of bias in systematic reviews.
- Surgical treatment showed a higher healing rate (62.1%) compared to conservative treatment (28.8%); however, the overall evidence quality was low and results were not statistically significant.
Article Abstract
Objective: The objective of this study was to compare the outcome of surgical and conservative treatment approaches for medication-related osteonecrosis of the jaw.
Study Design: Publications in Medline, The Cochrane Library, EMBASE, and PubMed (non-indexed articles) and by Health Technology Assessment organizations were searched. Quality of evidence in primary studies were assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE) and the level of bias in systematic reviews by a measurement tool to assess systematic reviews (AMSTAR).
Results: Quality assessment identified 3 primary studies with moderate GRADE score. Moderate risk of bias was found in 7 systematic reviews and low risk of bias in 3. Nine studies were included in the meta-analysis, where 62.1% healing was reported after surgical treatment (144 of 232 included patients) and 28.8% healing was reported after conservative treatment (38 of 132 included patients). Moderate heterogeneity was found among the included studies (P = .02). The overall odds ratio for resolution of osteonecrosis after surgical versus conservative treatment was 1.25 (95% confidence interval, 0.24-2.26) and was not statistically significant.
Conclusion: Slightly better outcomes are reported after surgical treatment, in particular for advanced disease stages, but there is a lack of standardized treatment protocols and outcome measures. Overall, the quality of evidence is poor, and the majority of studies have a low evidence certainty rating and high risk of bias.
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| http://dx.doi.org/10.1016/j.oooo.2021.09.009 | DOI Listing |
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