Medication-related osteonecrosis of the jaw. Implant presence-triggered osteonecrosis: Case series and literature review

Escobedo, M.F.; Cobo, Juan; Junquera, S.; Milla, J.; Olay, Sonsoles; Junquera, Luís

doi:10.1016/j.jormas.2019.04.012

Cited by 35 publications

(26 citation statements)

References 21 publications

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“…(#2) Plan implant rehabilitation in osteometabolic patients taking into account the cumulative dose of the drug already taken, the periodontal status, lifestyle (e.g., smoking), comorbidities and other drugs. Share with the patient a hypothetical medium to long-term MRONJ risk due to “implant presence-triggers” (such as peri-implantitis and micro-cracks), beside the lower probable short-term risk due to “implant surgery-triggers” [ 29 , 40 , 41 , 42 , 43 ]. Plan informed consent and semi-annual follow-ups (updated).…”

Section: The Six Issuesmentioning

confidence: 99%

Medication-Related Osteonecrosis of Jaws (MRONJ) Prevention and Diagnosis: Italian Consensus Update 2020

Campisi

Mauceri

Bertoldo

et al. 2020

IJERPH

121

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The Medication-Related Osteonecrosis of Jaws (MRONJ) diagnosis process and its prevention play a role of great and rising importance, not only on the Quality of Life (QoL) of patients, but also on the decision-making process by the majority of dentists and oral surgeons involved in MRONJ prevention (primary and secondary). The present paper reports the update of the conclusions from the Consensus Conference—held at the Symposium of the Italian Society of Oral Pathology and Medicine (SIPMO) (20 October 2018, Ancona, Italy)—after the newest recommendations (2020) on MRONJ were published by two scientific societies (Italian Societies of Maxillofacial Surgery and Oral Pathology and Medicine, SICMF and SIPMO), written on the inputs of the experts of the Italian Allied Committee on ONJ (IAC-ONJ). The conference focused on the topic of MRONJ, and in particular on the common practices at risk of inappropriateness in MRONJ diagnosis and therapy, as well as on MRONJ prevention and the dental management of patients at risk of MRONJ. It is a matter of cancer and osteometabolic patients that are at risk since being exposed to several drugs with antiresorptive (i.e., bisphosphonates and denosumab) or, more recently, antiangiogenic activities. At the same time, the Conference traced for dentists and oral surgeons some easy applicable indications and procedures to reduce MRONJ onset risk and to diagnose it early. Continuous updating on these issues, so important for the patient community, is recommended.

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Section: The Six Issuesmentioning

confidence: 99%

Medication-Related Osteonecrosis of Jaws (MRONJ) Prevention and Diagnosis: Italian Consensus Update 2020

Campisi

Mauceri

Bertoldo

et al. 2020

IJERPH

121

View full text Add to dashboard Cite

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“…Escobedo et al . ( 17 ), in a literature review and own series, concluded that peri-implant ONJ occurred more frequently in cases where implants had been loaded at least one year earlier (74 cases compared to 27 cases related to implant insertion). Our protocols take on board this highly significant point, because implant-wearing patients who commence treatment with antiresorptives should be warned that the risk of suffering ONJ will always exist owing to the very presence of the implant, and not just by its placement, therefore one way of preventing it would be not to place implants in any patient who is to be treated or is being treated with these drugs.…”

Section: Discussionmentioning

confidence: 99%

Proposal for a preventive protocol for medication-related osteonecrosis of the jaw

Romero-Ruiz

Romero-Serrano²,

Serrano-González³

et al. 2021

Med Oral

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Background Medication-related osteonecrosis of the jaw (MRONJ) is a severe adverse reaction experienced by some patients exposed to certain drugs (antiresorptives such as bisphosphonates or denosumab, and antiangiogenic drugs). From a review of the literature it appears that there is no uniform criterion when selecting preventive measures; these vary according to author. Likewise, the measures recommended are usually general, so that in few cases they result in specific actions to be applied depending on the different variables involved such as the type of drug used, the duration of its application, the underlying pathology, the presence or absence of risk factors, etc. The aim of this study has been to design a preventive protocol which can be easily applied in any clinic or by any dental care service. Material and Methods We undertook an exhaustive literature review to find any articles related to the topic of study, namely, preventive measures for medication-related osteonecrosis of the jaw, on the one hand generically and on the other focusing on dental implant treatment. The most part the criteria of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. From 3946 items, we selected a total of 21 items. Results From the analysis of the selected articles, several protocols have been developed that are easy to apply in a dental clinic.: Protocol 1. Before starting treatment with antiresorptives (Patients who are going to be treated for osteoporosis / Patients who are going to be treated for cancer). Protocol 2. Once treatment is initiated with antiresorptives (Patients being treated for osteoporosis / Patients being treated for cancer). Conclusions The application of these protocols requires an interdisciplinary team which can handle the various treatments and apply the measures contained in them. Along with a team of well-educated and trained dentists, it is equally important to maintain contact with the medical team involved in the treatment of the underlying pathology, especially rheumatologists, oncologists, internists and gynaecologists. All the above requires a great staff learning and organization effort, continuous training and coordination of the whole team involved in the preventive management of these patients. Key words: Medication-related osteonecrosis of the jaw, clinical protocols, clinical guidelines, prevention.

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“…However, they did not include data related to dental implant surgeries. Some studies examined dental implants and osteonecrosis; however, they used collective data from several clinics that were not representative of the total population (Escobedo et al., 2020; Giovannacci et al., 2016; Guazzo et al., 2017; Koka et al., 2010; Matsuo et al., 2016). This is the first study to investigate osteonecrosis using dental implant records from NHIS.…”

Section: Discussionmentioning

confidence: 99%

Is implant surgery a risk factor for osteonecrosis of the jaw in older adult patients with osteoporosis? A national cohort propensity score‐matched study

Ryu

Kim

Kwon

2021

Clinical Oral Implants Res

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Objectives This study aimed to investigate the association between dental implant therapy and osteonecrosis of the jaw (ONJ) in osteoporotic patients and the relationship between tooth extraction, dental implantation, and ONJ. Material and Methods This retrospective cohort study used the Customized Health Information Data from the National Health Insurance Corporation in South Korea. The study population included patients older than 70 years with a history of osteoporosis; the cases included patients who had undergone dental implant surgery between July 2014 and July 2016 with specific procedure codes. The case and control cohorts were stratified by tooth extraction because it was the strongest risk factor to consider in this study. Each group of patients was matched using the propensity score. To investigate the relationship between dental implants and ONJ, a Cox proportional hazard model was applied to socio‐economic factors, comorbidities, and bisphosphonates (BPs). All analyses were conducted using SAS statistical software. Results Based on the fully adjusted model, the propensity score‐matched osteoporosis patients with dental implants had a 0.51 times hazard ratio of osteonecrosis. On the contrary, tooth extraction was associated with a higher risk of ONJ (HR = 5.89). The patients with rheumatoid arthritis (RA) and those using BPs had a higher HR, respectively, 6.80 and 4.09 HR (p < .001). Conclusions Dental implantation was not a risk factor and patients with implants show rather lower ratios. However, older osteoporotic Korean patients who had undergone tooth extraction had higher risks of ONJ. A significantly higher risk of ONJ was associated with RA and BPs as well.

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Medication-related osteonecrosis of the jaw. Implant presence-triggered osteonecrosis: Case series and literature review

Cited by 35 publications

References 21 publications

Medication-Related Osteonecrosis of Jaws (MRONJ) Prevention and Diagnosis: Italian Consensus Update 2020

Medication-Related Osteonecrosis of Jaws (MRONJ) Prevention and Diagnosis: Italian Consensus Update 2020

Proposal for a preventive protocol for medication-related osteonecrosis of the jaw

Is implant surgery a risk factor for osteonecrosis of the jaw in older adult patients with osteoporosis? A national cohort propensity score‐matched study

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