Author:
Valamvanos Konstantinos,Valamvanos Theodoros-Filippos,Toumazou Spyridon,Gartzouni Eleni
Abstract
Medication-related osteonecrosis of the jaws (MRONJ) is a relatively rare but serious adverse drug reaction in patients under bone-targeting or antiangiogenic medication for malignant or osteometabolic diseases. The pathogenesis of MRONJ is multifactorial with the inhibition of osteoclasts and angiogenesis considered to play a keyrole in an individually susceptible environment, thus its prevalence is highly differentiated according to each study. Even though MRONJ has been reported since 2003 and the literature is expanding rapidly about possible risk factors, prevention and treatment options, the successful management with no recurrence is still under controversy. The conservative non-surgical (optimal oral hygiene, systemic antibiotic therapy) and surgical procedures (debridement, sequestrectomy or bone resection) are considered the treatment of choice especially at the early stages. Adjuvant therapies have been proposed to further stimulate bone and tissue healing such as teriparatide, bone morphogenic proteins, platelet concentrates, hyperbaric oxygen, ozone therapy, photodynamic therapy and lasers with promising results. The need to develop minimally invasive treatment protocols using novel technologies in particular for those patients with severe medical history has been highlighted in the literature. The clinical protocol that has been developed in our dental department, which is effectively contributing to MRONJ management and associates Photobiomodulation therapy (PBMT) with platelet-rich fibrin (A-PRF), will be presented in this article.
Reference43 articles.
1. Medication-related osteonecrosis of the jaw: definition and best practice for prevention, diagnosis, and treatment;Nicolatou-Galitis;Oral Surg Oral Med Oral Pathol Oral Radiol,2019
2. American Association of oral and maxillofacial surgeons position paper on medication-related osteonecrosis of the jaw- 2014 update;Ruggiero;J Oral Maxillofac Surg,2014
3. Medication-related osteonecrosis of the jaw: prevention, diagnosis and management in patients with cancer and bone metastasis;Otto;Cancer Treat Rev,2018
4. Platelet rich plasma in the treatment of bisphosphonate-related osteonecrosis of the jaw: personal experience and review of the literature;Longo;Int J Dent,2014
5. Non-exposed bisphosphonate-related osteonecrosis of the jaw: a critical assessment of current definition, staging, and treatment guidelines;Patel;Oral Dis,2012
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