Medication-related osteonecrosis of the jaw treatment modalities: A review
Abstract
Introduction: Medication-related osteonecrosis of the jaw (MRONJ) is a serious adverse reaction of antiresorptive and antiangiogenic agents. Management of MRONJ has remained a controversial topic within the oral and maxillofacial surgery community. Materials and Methods: Articles from 2010 to 2020 were selected. We determined that all review studies evaluated the effectiveness of various MRONJ therapies to resolve the condition were eligible for this study. We determined that all review studies evaluated the effectiveness of various MRONJ therapies to resolve the condition were eligible for this study. Results: Antibiotic therapy such as penicillin-based antibiotics plus β-lactamase inhibitor or metronidazole could decrease disease progression and may prevent super infection of the bone. Surgery should be considered in all stages of MRONJ as it confirms the histology. Fluorescence-guided surgery is helpful for MRONJ cases under Denosumab and it is recommended to use low level laser and PDT as adjuvant treatment of MRONJ.Conclusion: It seems that conservative treatment, minimally traumatic extraction technique, removal of bone edges and mucosal wound closure may prevent the occurrence of MRONJ. Keywords: Mronj; Bronj; Treatment; Prevention.
1. Di Fede O, Panzarella V, Mauceri R, Fusco V, Bedogni A, Lo Muzio L, et al. The Dental Management of Patients at Risk of Medication-Related Osteonecrosis of the Jaw: New Paradigm of Primary Prevention. BioMed research international. 2018;2018:2684924.
2. Beth-Tasdogan NH, Mayer B, Hussein H, Zolk O. Interventions for managing medication-related osteonecrosis of the jaw. The Cochrane database of systematic reviews. 2017;10:Cd012432.
3. Akashi M, Kusumoto J, Takeda D, Shigeta T, Hasegawa T, Komori T. A literature review of perioperative antibiotic administration in surgery for medication-related osteonecrosis of the jaw. Oral and maxillofacial surgery. 2018;22(4):369-78.
4. El-Rabbany M, Sgro A, Lam DK, Shah PS, Azarpazhooh A. Effectiveness of treatments for medication-related osteonecrosis of the jaw: A systematic review and meta-analysis. Journal of the American Dental Association (1939). 2017;148(8):584-94.e2.
5. Hayashida S, Soutome S, Yanamoto S, Fujita S, Hasegawa T, Komori T, et al. 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. Journal of Bone and Mineral Research. 2017;32(10):2022-9.
6. Hasegawa T, Kawakita A, Ueda N, Funahara R, Tachibana A, Kobayashi M, et al. 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? Osteoporosis International. 2017;28(8):2465-73.
7. Otto S, Ristow O, Pache C, Troeltzsch M, Fliefel R, Ehrenfeld M, et al. Fluorescence-guided surgery for the treatment of medication-related osteonecrosis of the jaw: a prospective cohort study. Journal of Cranio-Maxillofacial Surgery. 2016;44(8):1073-80.
8. Minamisako MC, Ribeiro GH, Lisboa ML, Mariela Rodríguez Cordeiro M, Grando LJ. Medication-related osteonecrosis of jaws: a low-level laser therapy and antimicrobial photodynamic therapy case approach. Case reports in dentistry. 2016;2016.
9. Rugani P, Acham S, Kirnbauer B, Truschnegg A, Obermayer-Pietsch B, Jakse N. Stage-related treatment concept of medication-related osteonecrosis of the jaw—a case series. Clinical oral investigations. 2015;19(6):1329-38.
10. Lopes RN, Rabelo GD, Rocha AC, Carvalho PAG, Alves FA. Surgical therapy for bisphosphonate-related osteonecrosis of the jaw: six-year experience of a single institution. Journal of Oral and Maxillofacial Surgery. 2015;73(7):1288-95.
11. Tenore G, Palaia G, Gaimari G, Brugnoletti O, Bove L, Giudice RL, et al. Medication-related osteonecrosis of the jaws (MRONJ): Etiological update. Senses and Sciences. 2014;1(4).
2. Beth-Tasdogan NH, Mayer B, Hussein H, Zolk O. Interventions for managing medication-related osteonecrosis of the jaw. The Cochrane database of systematic reviews. 2017;10:Cd012432.
3. Akashi M, Kusumoto J, Takeda D, Shigeta T, Hasegawa T, Komori T. A literature review of perioperative antibiotic administration in surgery for medication-related osteonecrosis of the jaw. Oral and maxillofacial surgery. 2018;22(4):369-78.
4. El-Rabbany M, Sgro A, Lam DK, Shah PS, Azarpazhooh A. Effectiveness of treatments for medication-related osteonecrosis of the jaw: A systematic review and meta-analysis. Journal of the American Dental Association (1939). 2017;148(8):584-94.e2.
5. Hayashida S, Soutome S, Yanamoto S, Fujita S, Hasegawa T, Komori T, et al. 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. Journal of Bone and Mineral Research. 2017;32(10):2022-9.
6. Hasegawa T, Kawakita A, Ueda N, Funahara R, Tachibana A, Kobayashi M, et al. 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? Osteoporosis International. 2017;28(8):2465-73.
7. Otto S, Ristow O, Pache C, Troeltzsch M, Fliefel R, Ehrenfeld M, et al. Fluorescence-guided surgery for the treatment of medication-related osteonecrosis of the jaw: a prospective cohort study. Journal of Cranio-Maxillofacial Surgery. 2016;44(8):1073-80.
8. Minamisako MC, Ribeiro GH, Lisboa ML, Mariela Rodríguez Cordeiro M, Grando LJ. Medication-related osteonecrosis of jaws: a low-level laser therapy and antimicrobial photodynamic therapy case approach. Case reports in dentistry. 2016;2016.
9. Rugani P, Acham S, Kirnbauer B, Truschnegg A, Obermayer-Pietsch B, Jakse N. Stage-related treatment concept of medication-related osteonecrosis of the jaw—a case series. Clinical oral investigations. 2015;19(6):1329-38.
10. Lopes RN, Rabelo GD, Rocha AC, Carvalho PAG, Alves FA. Surgical therapy for bisphosphonate-related osteonecrosis of the jaw: six-year experience of a single institution. Journal of Oral and Maxillofacial Surgery. 2015;73(7):1288-95.
11. Tenore G, Palaia G, Gaimari G, Brugnoletti O, Bove L, Giudice RL, et al. Medication-related osteonecrosis of the jaws (MRONJ): Etiological update. Senses and Sciences. 2014;1(4).
| Files | ||
| Issue | Vol 7, No 1 (Winter 2020) | |
| Section | Review Article(s) | |
| DOI | https://doi.org/10.18502/jcr.v7i1.4005 | |
| Keywords | ||
| Mronj; Bronj; Treatment; Prevention. | ||
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Asadi AA. Medication-related osteonecrosis of the jaw treatment modalities: A review. J Craniomaxillofac Res. 2020;7(1):1-4.
