Skip to main content
AAO-HNSF 2025 Annual Meeting & OTO EXPO Main banner
Icon Legend
This session is not in your schedule.
This session is in your schedule. Click again to remove it.
Rate ePoster
Video

Head and Neck Surgery

(A634) Social Vulnerability and Management of Depression and Anxiety in Medication-related Osteonecrosis of the Jaw

Monday, October 13, 2025
12:00 PM - 1:00 PM EDT
Location: OTO EXPO, Posters

    Presenting Author(s)

  • Christie Hung, AB

    Medical Student
    New York University Grossman School of Medicine
    New York, New York, United States

    • Co-Author(s)

  • CH

    Colin Hill, MD

    Department of Radiation Oncology at NYU Grossman School of Medicine, United States

    • Senior Author(s)

  • Lindsey E. Moses, MD

    Clinical Assistant Professor of Otolaryngology-Head and Neck Surgery
    Department of Otolaryngology-Head and Neck Surgery at NYU Grossman School of Medicine
    Brooklyn, NY, United States

Disclosure(s):
Christie Hung, AB: No relevant relationships to disclose.
Lindsey E. Moses, MD: No relevant relationships to disclose.


Introduction: Medication-related osteonecrosis of the jaw (MRONJ) is a rare, but debilitating disease linked to exposure to anti-angiogenic and antiresorptive drugs for cancer or osteoporosis. Patients often experience pain and reduced quality of life, leading to increased symptoms of anxiety and depression. There is limited data on the impact of social factors on the diagnosis and treatment of anxiety and major depression in patients with MRONJ.

Methods: This is a population-based, cross-sectional study using Epic Cosmos, a national database that includes >289 million patients from >1600 hospitals and clinics across the United States, as well as Saudi Arabia and Lebanon. ICD-10 codes were used to identify patients with a diagnosis of MRONJ between January 2007 and December 2024. Patients were stratified by the CDC Social Vulnerability Index (SVI) at the zip code level. Outcomes studied include the rate of diagnosis of anxiety and/or major depression within 2 years of MRONJ diagnosis and treatment rate with antidepressants or anti-anxiety medications within 2 years of MRONJ diagnosis. Statistical significance was determined using chi-squared tests.

Results: 18,104 patients were identified with MRONJ. 19.7% (3,570) and 30.2% (5,484) were in the 1st and 4th SVI quartiles, respectively. The overall rate of diagnosis of anxiety and/or major depression within 2 years of MRONJ diagnosis was 27.6% and the overall prescription rate with antidepressants or anti-anxiety medications within 2 years of MRONJ diagnosis was 27.7%. The most socially vulnerable quartile (highest SVI) was associated with lower rates of diagnosis (25.7% in the highest SVI quartile vs. 28.9% in the lowest quartile, p< 0.05) and medication treatment (25.2% in the highest quartile vs. 30.2% in the lowest quartile, p< 0.05) than the lowest SVI quartile.

Conclusions: This study demonstrates disparities in the rate of diagnosis and treatment of anxiety and depression among patients with MRONJ based on social vulnerability with lower rates of diagnosis and treatment seen among the most socially vulnerable patients.