{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T16:48:36Z","timestamp":1783183716284,"version":"3.54.6"},"reference-count":50,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2022,6,17]],"date-time":"2022-06-17T00:00:00Z","timestamp":1655424000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Although maxillary sinusitis often occurs in patients with medication-related osteonecrosis of the jaw (MRONJ) of the upper jaw, there have been few reports on the treatment and outcomes for maxillary sinusitis associated with maxillary MRONJ. This study aimed to retrospectively investigate the treatment outcomes of maxillary sinusitis in patients with MRONJ of the upper jaw. There were 34 patients diagnosed with maxillary MRONJ and sinusitis by preoperative computed tomography who underwent surgery in our institution between January 2011 and December 2019. Age, sex, primary disease, stage of MRONJ, class and administration period of an antiresorptive agent, corticosteroid administration, preoperative leukocyte count and serum albumin level, periosteal reaction, sinusitis grade, maxillary sinus surgical procedure, and treatment outcomes of MRONJ and sinusitis were examined. There were 7 male and 27 female patients (average age, 74.7 years). Complete healing of MRONJ was obtained in 29 of 34 patients (85.3%). Maxillary sinusitis resolved or improved in 21 patients (61.8%) but did not change or worsen in 13 patients (38.2%). We found that complete resection of necrotic bone with intraoperative irrigation of the maxillary sinus may provide good treatment outcomes for maxillary sinusitis associated with MRONJ, although our findings were not statistically significant owing to the small number of patients.<\/jats:p>","DOI":"10.3390\/ijerph19127430","type":"journal-article","created":{"date-parts":[[2022,6,17]],"date-time":"2022-06-17T05:25:11Z","timestamp":1655443511000},"page":"7430","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Retrospective Analysis of Treatment Outcomes of Maxillary Sinusitis Associated with Medication-Related Osteonecrosis of the Jaw"],"prefix":"10.3390","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2173-536X","authenticated-orcid":false,"given":"Mitsunobu","family":"Otsuru","sequence":"first","affiliation":[{"name":"Department of Clinical Oral Oncology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8588, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saki","family":"Hayashida","sequence":"additional","affiliation":[{"name":"Department of Clinical Oral Oncology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8588, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4348-6699","authenticated-orcid":false,"given":"Kota","family":"Morishita","sequence":"additional","affiliation":[{"name":"Department of Clinical Oral Oncology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8588, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maho","family":"Murata","sequence":"additional","affiliation":[{"name":"Department of Clinical Oral Oncology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8588, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sakiko","family":"Soutome","sequence":"additional","affiliation":[{"name":"Department of Oral Health, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8588, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miho","family":"Sasaki","sequence":"additional","affiliation":[{"name":"Department of Radiology and Biomedical Informatics, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8588, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9031-1253","authenticated-orcid":false,"given":"Yukinori","family":"Takagi","sequence":"additional","affiliation":[{"name":"Department of Radiology and Biomedical Informatics, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8588, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Misa","family":"Sumi","sequence":"additional","affiliation":[{"name":"Department of Radiology and Biomedical Informatics, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8588, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahiro","family":"Umeda","sequence":"additional","affiliation":[{"name":"Department of Clinical Oral Oncology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8588, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,6,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1938","DOI":"10.1016\/j.joms.2014.04.031","article-title":"American Association of Oral and Maxillofacial Surgeons position paper on medication-related os-teonecrosis of the jaw\u20142014 update","volume":"72","author":"Ruggiero","year":"2014","journal-title":"J. Oral Maxillofac. Surg."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1007\/s00774-016-0810-7","article-title":"Antiresorptive agent-related osteonecrosis of the jaw: Position Paper 2017 of the Japanese Allied Committee on Osteonecrosis of the Jaw","volume":"35","author":"Yoneda","year":"2016","journal-title":"J. Bone Miner. Metab."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"920","DOI":"10.1016\/j.joms.2022.02.008","article-title":"American Association of Oral and Maxil-lofacial Surgeons\u2019 Position Paper on Medication-Related Osteonecrosis of the Jaws-2022 Update","volume":"80","author":"Ruggiero","year":"2022","journal-title":"J. Oral Maxillofac. Surg."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1986","DOI":"10.1016\/j.joms.2020.05.037","article-title":"Can Surgical Management Improve Resolution of Medication-Related Osteonecrosis of the Jaw at Early Stages? A Prospective Cohort Study","volume":"78","author":"Giudice","year":"2020","journal-title":"J. Oral Maxillofac. Surg."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1111\/odi.12764","article-title":"Medication-related osteonecrosis of the jaw: Surgical or non-surgical treatment?","volume":"24","author":"Favia","year":"2018","journal-title":"Oral Dis."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1049","DOI":"10.1016\/j.oraloncology.2014.08.016","article-title":"A systematic review of therapeutical approaches in bisphosphonates-related osteonecrosis of the jaw (BRONJ)","volume":"50","author":"Rupel","year":"2014","journal-title":"Oral Oncol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"568","DOI":"10.1016\/j.ijom.2015.01.026","article-title":"Treatment strategies and outcomes of bisphosphonate-related osteonecrosis of the jaw (BRONJ) with characterization of patients: A systematic review","volume":"44","author":"Fliefel","year":"2015","journal-title":"Int. J. Oral Maxillofac. Surg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"2022","DOI":"10.1002\/jbmr.3191","article-title":"Evaluation of the Treatment Strategies for Medication-Related Osteonecrosis of the Jaws (MRONJ) and the Factors Affecting Treatment Outcome: A Multicenter Retrospective Study with Propensity Score Matching Analysis","volume":"32","author":"Hayashida","year":"2017","journal-title":"J. Bone Miner. Res."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"885","DOI":"10.1016\/j.jds.2020.12.007","article-title":"Surgical strategy for medication-related osteonecrosis of the jaw (MRONJ) on maxilla: A multicenter retrospective study","volume":"16","author":"Okuyama","year":"2020","journal-title":"J. Dent. Sci."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"408","DOI":"10.1016\/j.ajoms.2021.01.012","article-title":"Treatment and outcome of maxillary sinusitis associated with maxillary medication-related osteonecrosis","volume":"33","author":"Sawada","year":"2021","journal-title":"J. Oral Maxillofac. Surg. Med. Pathol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1007\/BF02347976","article-title":"Usefulness of CT images for diagnosis of odontogenic maxillary sinusitis","volume":"11","author":"Kurabayashi","year":"1995","journal-title":"Oral Radiol."},{"key":"ref_12","first-page":"2","article-title":"American Association of Oral and Maxillofacial Surgeons position paper on bisphosphonate-related os-teonecrosis of the jaws\u20142009 Update","volume":"67","author":"Ruggiero","year":"2009","journal-title":"J. Oral Maxillofac. Surg."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1567","DOI":"10.1016\/j.joms.2005.07.010","article-title":"Bisphosphonate-Induced Exposed Bone (Osteonecrosis\/Osteopetrosis) of the Jaws: Risk Factors, Recognition, Prevention, and Treatment","volume":"63","author":"Marx","year":"2005","journal-title":"J. Oral Maxillofac. Surg."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"850","DOI":"10.1016\/j.joms.2008.11.015","article-title":"Bisphosphonate-Related Osteonecrosis of the Jaws: A Single-Center Study of 101 Patients","volume":"67","author":"Lazarovici","year":"2009","journal-title":"J. Oral Maxillofac. Surg."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"977","DOI":"10.1016\/j.oraloncology.2013.05.012","article-title":"Conservative management of bisphospho-nate-related osteonecrosis of the jaws: Staging and treatment outcomes","volume":"49","author":"Lerman","year":"2013","journal-title":"Oral Oncol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"2332","DOI":"10.1016\/j.joms.2018.05.025","article-title":"Nonsurgical Management of Medication-Related Osteonecrosis of the Jaws Using Local Wound Care","volume":"76","author":"Hadaya","year":"2018","journal-title":"J. Oral Maxillofac. Surg."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1016\/j.oraloncology.2010.11.007","article-title":"Surgery-triggered and non surgery-triggered Bisphosphonate-related Osteonecrosis of the Jaws (BRONJ): A retrospective analysis of 567 cases in an Italian multicenter study","volume":"47","author":"Vescovi","year":"2011","journal-title":"Oral Oncol."},{"key":"ref_18","first-page":"907","article-title":"Outcome of treatment and parameters influencing recurrence in patients with bisphosphonate-related osteonecrosis of the jaws","volume":"137","author":"Koschinski","year":"2010","journal-title":"J. Cancer Res. Clin. Oncol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"2501","DOI":"10.1016\/j.joms.2012.05.019","article-title":"Resective Surgical Approach Shows a High Performance in the Management of Advanced Cases of Bisphosphonate-Related Osteonecrosis of the Jaws: A Retrospective Survey of 347 Cases","volume":"70","author":"Graziani","year":"2012","journal-title":"J. Oral Maxillofac. Surg."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1111\/j.1600-0714.2011.01091.x","article-title":"Bisphosphonates-related osteonecrosis of the jaws: A concise review of the literature and a report of a single-centre experience with 151 patients","volume":"41","author":"Vescovi","year":"2011","journal-title":"J. Oral Pathol. Med."},{"key":"ref_21","first-page":"w13605","article-title":"Osteopathology of the jaw associated with bone re-sorption inhibitors: What have we learned in the last 8 years?","volume":"142","author":"Jacobsen","year":"2012","journal-title":"Swiss Med. Wkly."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1016\/j.oraloncology.2011.11.004","article-title":"The Saxon Bisphosphonate Register\u2013Therapy and prevention of bisphosphonate-related osteonecrosis of the jaws","volume":"48","author":"Schubert","year":"2012","journal-title":"Oral Oncol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"S94","DOI":"10.1016\/j.joms.2015.09.024","article-title":"Disease stage and mode of therapy are important determinants of treatment outcome for medica-tionrelated osteonecrosis of the jaw","volume":"73","author":"Ruggiero","year":"2015","journal-title":"J. Oral Maxillofac Surg."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1016\/j.jcms.2015.12.017","article-title":"The role of mylohyoid flap in the treatment of bisphosphonate-related osteonecrosis of the jaws","volume":"44","author":"Koerdt","year":"2016","journal-title":"J. Cranio-Maxillofac. Surg."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"930","DOI":"10.1016\/j.bjoms.2016.06.015","article-title":"Conservative surgical management of patients with bisphosphonate-related osteonecrosis of the jaws: A series of 120 patients","volume":"54","author":"Nisi","year":"2016","journal-title":"Br. J. Oral Maxillofac. Surg."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1404","DOI":"10.1016\/j.joms.2016.12.014","article-title":"Extensive Surgical Procedures Result in Better Treatment Outcomes for Bisphosphonate-Related Osteonecrosis of the Jaw in Patients with Osteoporosis","volume":"75","author":"Kim","year":"2016","journal-title":"J. Oral Maxillofac. Surg."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1183","DOI":"10.1016\/j.jcms.2017.05.027","article-title":"The impact of surgical intervention and antibiotics on MRONJ stage II and III\u2014Retrospective study","volume":"45","author":"Zirk","year":"2017","journal-title":"J. Cranio-Maxillofac. Surg."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"568","DOI":"10.1016\/j.jcms.2011.10.012","article-title":"Incidence of maxillary sinusitis and oro-antral fistulae in bisphosphonate-related osteonecrosis of the jaw","volume":"40","author":"Mast","year":"2012","journal-title":"J. Cranio-Maxillofac. Surg."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"996","DOI":"10.1016\/j.anl.2020.05.013","article-title":"Relationships of opacification in the nasal sinuses, rhinosinusitis, and antiresorptive agent-related osteonecrosis of the jaw","volume":"47","author":"Matsumoto","year":"2020","journal-title":"Auris Nasus Larynx"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1016\/j.ijom.2010.11.006","article-title":"Bisphosphonate-related osteonecrosis of the maxilla and sinusitis maxillaris","volume":"40","author":"Maurer","year":"2011","journal-title":"Int. J. Oral Maxillofac. Surg."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"962","DOI":"10.1111\/odi.13615","article-title":"Medication-related osteonecrosis of the maxilla: Prognosis of oral surgery combined with endoscopic sinus surgery","volume":"27","author":"Park","year":"2020","journal-title":"Oral Dis."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"2465","DOI":"10.1007\/s00198-017-4063-7","article-title":"A multicenter retrospective study of the risk factors associated with medication-related osteonecrosis of the jaw after tooth extraction in patients receiving oral bisphosphonate therapy: Can primary wound closure and a drug holiday really prevent MRONJ?","volume":"28","author":"Hasegawa","year":"2017","journal-title":"Osteoporos. Int."},{"key":"ref_33","first-page":"e1051","article-title":"The role of Leucocyte-rich and platelet-rich fibrin (L-PRF) in the treatment of the medication-related osteonecrosis of the jaws (MRONJ)","volume":"9","year":"2017","journal-title":"J. Clin. Exp. Dent."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"2082","DOI":"10.1016\/j.joms.2015.06.165","article-title":"Stage 3 Medication-Related Osteonecrosis of the Posterior Maxilla: Surgical Treatment Using a Pedicled Buccal Fat Pad Flap: Case Reports","volume":"73","author":"Berrone","year":"2015","journal-title":"J. Oral Maxillofac. Surg."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1007\/s10006-021-00973-9","article-title":"Outcomes of sequestrectomy and buccal fat pad reconstruction in the management of medication-related osteonecrosis of the jaws","volume":"26","author":"Jose","year":"2022","journal-title":"Oral Maxillofac. Surg."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1321","DOI":"10.1016\/j.joms.2007.03.019","article-title":"Hyperbaric oxygen treatment and bisphosphonate-induced osteonecrosis of the jaw: A case series","volume":"65","author":"Freiberger","year":"2007","journal-title":"J. Oral Maxillofac. Surg."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"468","DOI":"10.1089\/pho.2014.3742","article-title":"Low-Level Laser Therapy Supported Surgical Treatment of Bisphosphonate Related Osteonecrosis of Jaws: A Retrospective Analysis of 11 Cases","volume":"32","author":"Altay","year":"2014","journal-title":"Photomed. Laser Surg."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"92","DOI":"10.15171\/jlms.2018.19","article-title":"Combined approach to treat medi-cation-related osteonecrosis of the jaws","volume":"9","author":"Merigo","year":"2018","journal-title":"J. Lasers Med. Sci."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"787","DOI":"10.1016\/j.bjoms.2017.06.014","article-title":"Medication-related osteonecrosis of the jaw in oncological patients with skeletal metastases: Conservative treatment is effective up to stage 2","volume":"55","author":"Coropciuc","year":"2017","journal-title":"Br. J. Oral Maxillofac. Surg."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1176","DOI":"10.1016\/j.joms.2016.12.005","article-title":"Does the addition of bone morphogenetic protein 2 to platelet-rich fibrin improve healing after treatment for medication-related osteonecrosis of the jaw?","volume":"75","author":"Park","year":"2017","journal-title":"J. Oral Maxillofac. Surg."},{"key":"ref_41","first-page":"1741","article-title":"Bisphosphonate-related osteonecrosis of the jaw (BRONJ): 5 year experience in the treatment of 131 cases with ozone therapy","volume":"16","author":"Agrillo","year":"2012","journal-title":"Eur. Rev. Med. Pharmacol. Sci."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"2721","DOI":"10.1007\/s00198-011-1882-9","article-title":"Short-term teriparatide therapy as an adjunctive modality for bisphosphonate-related osteonecrosis of the jaws","volume":"23","author":"Kwon","year":"2012","journal-title":"Osteoporos. Int."},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Giudice, A., Antonelli, A., Chiarella, E., Baudi, F., Barni, T., and Di Vito, A. (2020). The Case of Medication-Related Osteonecrosis of the Jaw Addressed from a Pathogenic Point of View. Innovative Therapeutic Strategies: Focus on the Most Recent Discoveries on Oral Mesenchymal Stem Cell-Derived Exosomes. Pharmaceuticals, 13.","DOI":"10.3390\/ph13120423"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"975","DOI":"10.1007\/s13770-021-00372-x","article-title":"Effect of Human Umbilical Cord Matrix-Derived Mesenchymal Stem Cells on Bisphosphonate-Related Osteonecrosis of the Jaw","volume":"18","author":"Yang","year":"2021","journal-title":"Tissue Eng. Regen. Med."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1017\/S0022215121002280","article-title":"Direct maxillary irrigation therapy in non-operated chronic sinusitis: A prospective randomised controlled trial","volume":"136","author":"Ronen","year":"2021","journal-title":"J. Laryngol. Otol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"528","DOI":"10.1177\/000348948309200524","article-title":"Irrigation of the Maxillary Sinus by Canine Fossa Puncture: Experience with 202 Patients","volume":"92","author":"Gay","year":"1983","journal-title":"Ann. Otol. Rhinol. Laryngol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s40902-017-0115-3","article-title":"Novel approach to the maxillary sinusitis after sinus graft","volume":"39","author":"Hong","year":"2017","journal-title":"Maxillofac. Plast. Reconstr. Surg."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"913","DOI":"10.1007\/s00774-019-00994-1","article-title":"Clinical significance of periosteal reaction as a predictive factor for treatment outcome of medica-tion-related osteonecrosis of the jaw","volume":"37","author":"Kojima","year":"2019","journal-title":"J. Bone Min. Metab."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1007\/s00774-020-01154-6","article-title":"Effect of periosteal reaction in medication-related osteonecrosis of the jaw on treatment outcome after surgery","volume":"39","author":"Soutome","year":"2020","journal-title":"J. Bone Miner. Metab."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"6361","DOI":"10.1007\/s00520-021-06214-9","article-title":"Periosteal reaction of medication-related osteonecrosis of the jaw (MRONJ): Clinical significance and changes during conservative therapy","volume":"29","author":"Soutome","year":"2021","journal-title":"Support. Care Cancer"}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/12\/7430\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T23:33:40Z","timestamp":1760139220000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/12\/7430"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,6,17]]},"references-count":50,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2022,6]]}},"alternative-id":["ijerph19127430"],"URL":"https:\/\/doi.org\/10.3390\/ijerph19127430","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,6,17]]}}}