Regional variation and healthcare utilization patterns in Medication-related osteonecrosis of the jaw: A nationwide cohort study in Korea

Abstract

BACKGROUND: Medication-related osteonecrosis of the jaw (MRONJ) is a serious complication associated with antiresorptive and antiangiogenic agents. This study evaluated regional differences in MRONJ diagnosis and surgical management in Korea. METHODS: Using the National Health Insurance Service-Health Screening Cohort, individuals aged ≥50 years between 2010 and 2019 were analyzed. MRONJ cases were identified using KCD-7 diagnosis and procedure codes. RESULTS: A total of 4,493 MRONJ diagnoses and 1,671 surgical treatments were identified. Diagnoses and surgeries were most frequent in Gyeonggi-do, Seoul, and Gyeongsangbuk-do, whereas relative burden was higher in several non-metropolitan regions. Care was concentrated in tertiary general hospitals and dental hospitals. Region-out diagnosis and surgery rates were highest in Gyeonggi-do (40.8% and 28.4%, respectively), with significant regional differences in healthcare utilization (p < .001). . CONCLUSIONS: Regional disparities exist in MRONJ diagnosis and surgical management in Korea, suggesting imbalances in healthcare resources, specialized care access, and referral patterns.