Medication-related osteonecrosis of the jaw: A literature review |
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| Affiliation: | 1. Department of Medicine, Divisions of Endocrinology and Metabolism and Geriatrics, McMaster University, Hamilton, ON, Canada;2. Division of Oral and Maxillofacial Surgery, Dalhousie University, Halifax, NS, Canada;3. Department of Medicine, Division of Endocrinology, University of British Columbia, Vancouver, BC, Canada;4. Division of Bone Diseases, Geneva University Hospitals, Geneva, Switzerland;5. Departments of Medicine, Community Health Sciences and Oncology, University of Calgary, Calgary, AB, Canada;6. Centre of Muscle & Bone Research, Charité-University Medicine Berlin, Campus Benjamin Franklin, Free University & Humboldt University Berlin, Berlin, Germany;7. Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA;8. Division of Maxillofacial Surgery, Kaiser Permanente Oakland Medical Center, Oakland, CA, USA;9. Department of Medicine, University of Auckland, Auckland, New Zealand;10. Division of Oral and Maxillofacial Surgery, Hofstra North Shore-LIJ School of Medicine, Hempstead, NY, USA;11. Stony Brook School of Dental Medicine, Stony Brook, NY, USA;12. New York Center for Orthognathic and Maxillofacial Surgery, New York, NY, USA;13. Department of Oral and Maxillofacial Radiology, School of Dentistry, Matsumoto Dental University, Shojiri, Japan;14. Division of Diagnostic and Surgical Sciences, UCLA School of Dentistry, Los Angeles, CA, USA;15. Mercy Health Osteoporosis and Bone Health Services, Cincinnati, OH, USA;16. Department of Surgery and Translational Medicine, University of Florence, Florence, Italy;17. Department of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada;18. Department of Medicine, Division of Endocrinology at Indiana University, Indianapolis, IN, USA;19. Department of Human Metabolism, University of Sheffield, Sheffield, UK;20. Department of Medicine, University of Toronto, Toronto, ON, Canada;21. Centre of Excellence in Skeletal Health Assessment, Joint Department of Medical Imaging, University Health Network (UHN), Toronto, ON, Canada;22. Mount Sinai Hospital, University of Toronto, Toronto, ON, Canada;23. Department of Medicine, McGill University, Montreal, QC, Canada;24. Jordan Osteoporosis Center, Jordan Hospital & Medical Center, Amman, Jordan;25. MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK;26. NIHR Nutrition Biomedical Research Centre, University of Southampton, Southampton, UK;27. NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UK;28. Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham Osteoporosis Prevention and Treatment Clinic, Birmingham, AL, USA;29. Division of Endocrinology and Metabolism, Department of Internal Medicine, Medical University Graz, Graz, Austria;30. Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark;31. Faculty of Dentistry, University of Toronto, Toronto, Canada;32. Department of Education, University of Victoria,Victoria, BC, Canada;33. Department of Oral and Maxillofacial Surgery, Oulu University Hospital, University of Oulu, Oulu, Finland;34. Division of Endocrinology and Metabolism, University of Toronto, Toronto, ON, Canada;35. Division of Orthopaedic Surgery, Department of Surgery, Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada;36. Faculty of Dentistry, University of Toronto, Toronto, ON, Canada;37. International Osteoporosis Foundation (IOF), Nyon, Switzerland;38. College of Medicine, King Saud University, Riyadh, Saudi Arabia;39. Department of Dental Oncology, Northeast Cancer Centre/Health Science North, Sudbury, ON, Canada;40. Rheumatology Division, CHU de Québec Research Centre, Laval University, Quebec City, QC, Canada;41. Department of Medicine, Cambridge Biomedical Campus, Cambridge, UK |
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| Abstract: | BackgroundAntiresorptive agents such as bisphosphonates and denosumab, as well as angiogenesis inhibitors, may induce medication-related osteonecrosis of the jaw (MRONJ). However, the exact mechanisms of MRONJ are unclear and definitive treatment strategies have not yet been developed. Moreover, the aging population requiring antiresorptive agents and angiogenesis inhibitors has been increasing worldwide. Therefore, the aim of this literature review was to introduce the latest information on MRONJ. The epidemiology, triggering factors, risk factors, drug holiday, pathoetiology and treatment strategies for each drug-induced ONJ were investigated by conducting a PubMed search.HighlightThe prevalence and incidence of ONJ were very low. Some mechanisms of ONJ have been identified, although they were not definitive. Novel treatment strategies have been proposed in basic and clinical research. Several factors, including age and the administration duration of bisphosphonates, are risks for the development of bisphosphonate-related ONJ (BRONJ). Dental implant therapy and peri-implantitis could become risk factors of BRONJ, regardless of the onset timing of bisphosphonates. No reliable information about ONJ induced by denosumab and angiogenesis inhibitors was found.ConclusionCaution should be taken when dental treatment including implant therapy is performed in patients receiving bisphosphonates, denosumab, and angiogenesis inhibitors. There is limited scientific evidence regarding the relationship between MRONJ and older age. Further ONJ-related research on the aging population is required to manage the treatment of such diseases in older people in the future. |
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| Keywords: | Osteonecrosis Bisphosphonates Denosumab Angiogenesis Inhibitors Antiresorptive Agentst |
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