Trend Analysis of Medically Related Osteonecrosis of the Jaw in the United States Using US National Inpatient Data From 2016 to 2022

OBJECTIVES: This study presents a trend analysis of Medication-Related Osteonecrosis of the Jaw (MRONJ) using US National Inpatient Sample (NIS) data from 2016 to 2022, providing insights into its epidemiology, comorbidities, and economics. METHODS: A retrospective cross-sectional analysis was performed using US MRONJ hospital admissions. Prevalence rates were calculated relative to Bisphosphonate patient numbers in the United States and hospital-based denominators. Statistical analyses included two-sample proportion (Z) tests, Cochran-Armitage trend tests, Welch t-tests, and multivariable linear and ANOVA models with false discovery rate (FDR) correction for multiple comparisons, effect sizes, market basket analysis. RESULTS: Cochran-Armitage trend tests revealed significant increasing trends in MRONJ prevalence across all denominators: total NIS hospitalizations (p = 0.037), dental-related hospitalizations (p = 0.012), and bisphosphonate-exposed patients (p < 0.001). Females were more affected with MRONJ than males consistently across all years (p = 0.188). Whites had the highest number of cases across all years (p = 0.774). No region or income bracket stood out as highest or lowest. Medicare is the primary payer with 61%-80% of patients covered (p = 0.497). The average age of patients is around 70 years across all years. The average length of stay in the hospital ranged from 4 to 8 days and the average daily charges ranged from $15,000 to $20,000. Hypertension is the most common co-morbidity (except 2018). CONCLUSION: The study highlights the incidence of MRONJ, its demographic disparities, economics, and the need for enhanced prevention and cost-effective management strategies.