Medication related osteonecrosis of the jaws. Literature review
Paris TAMIOLAKIS, Griogorios THERMOS, Anastasios CHAROULIS, Εvanthia CHRYSOMALI, Alexandra SKLAVOUNOU-ANDRIKOPOULOU
Department of Oral Medicine and Pathology, School of Dentistry, National and Kapodistrian University of Athens, Greece (Head: Professor A. Sklavounou-Andrikopoulou)
Hellenic Archives of Oral & Maxillofacial Surgery (2018) 1, 11-34
SUMMARY: Medication related osteonecrosis of the jaws (MRONJ) is a clinical entity that may develop in patients receiving antiresorprtive (bisphosphonates and deno- sumab) or antiangiogenic agents. The main objective of this article is to review the pertinent literature regarding medications that may cause MRONJ, its pathophysiology, etiologic factors, epidemiological, radiological and clini- copathological features as well as therapeutic approaches. It is critical for the dentist, to inform the patients at risk for developing MRONJ, to be able to timely diagnose the disease in order to contribute to its prevention and proper management. Diagnosis is based on the patient’s medical history and clinical findings. Medical history should be thoroughly investigated with emphasis on medications related to MRONJ. Maintenance of an ex- cellent oral hygiene and intensive dental care before and during treatment, are preventive measures aiming to re- duce the risk of MRONJ. Treatment protocol is related to the stage of the disease and ranges from conservative management (topical antimicrobial agents in combination with systemic antibiotics), to surgical interventions per- formed by specialized surgeons. Histopathological exam- ination of the surgically removed specimens is mandatory in order to exclude other pathological conditions or metastatic disease.
KEY WORDS: Osteonecrosis of the jaws, Medication re- lated Osteonecrosis of the jaws
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Yarom N, Lazarovici TS, Whitefield S, Weissman T, Wasserzug O, Yahalom R. Rapid onset of osteonecrosis of the jaw in patients switching from bisphosphonates to denosumab. Oral Surg Oral Med Oral Pathol Oral Radiol doi: 10.1016/j.oooo.2017.09.014, 2017
Department of Oral Medicine and Pathology, School of Dentistry, National and Kapodistrian University of Athens, Greece (Head: Professor A. Sklavounou-Andrikopoulou)
Hellenic Archives of Oral & Maxillofacial Surgery (2018) 1, 11-34
SUMMARY: Medication related osteonecrosis of the jaws (MRONJ) is a clinical entity that may develop in patients receiving antiresorprtive (bisphosphonates and deno- sumab) or antiangiogenic agents. The main objective of this article is to review the pertinent literature regarding medications that may cause MRONJ, its pathophysiology, etiologic factors, epidemiological, radiological and clini- copathological features as well as therapeutic approaches. It is critical for the dentist, to inform the patients at risk for developing MRONJ, to be able to timely diagnose the disease in order to contribute to its prevention and proper management. Diagnosis is based on the patient’s medical history and clinical findings. Medical history should be thoroughly investigated with emphasis on medications related to MRONJ. Maintenance of an ex- cellent oral hygiene and intensive dental care before and during treatment, are preventive measures aiming to re- duce the risk of MRONJ. Treatment protocol is related to the stage of the disease and ranges from conservative management (topical antimicrobial agents in combination with systemic antibiotics), to surgical interventions per- formed by specialized surgeons. Histopathological exam- ination of the surgically removed specimens is mandatory in order to exclude other pathological conditions or metastatic disease.
KEY WORDS: Osteonecrosis of the jaws, Medication re- lated Osteonecrosis of the jaws
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