Medication-related osteonecrosis of the jaw: An institution’s experience

Altay, Mehmet Ali; Radu, Alexandra; Pack, Sean; Yıldırımyan, Nelli; Flores-Hidalgo, Andres; Baur, Dale A.; Quereshy, Faisal A.

doi:10.1080/08869634.2018.1528711

Cited by 6 publications

(5 citation statements)

References 25 publications

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“…By coupling the “Number of patients/Number of lesions” and “Number of patients with multiple lesions”, 30 studies reported having patients with multiple lesions although the exact number of patients was not disclosed in 12 of these studies [ 43 , 47 , 53 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 ] ( Figure 2 e) ( Table S2 ). Thirteen studies did not specify if patients had multisite lesions or not ( Figure 2 d) ( Table S2 ).…”

Section: Resultsmentioning

confidence: 99%

“…In six studies, the primary outcome was evaluated at the last follow-up visit, between 2 and 12 months [ 43 , 50 , 56 , 57 , 72 , 75 ]. In nine studies, the authors did not specify when the primary outcome was evaluated [ 13 , 37 , 53 , 55 , 58 , 62 , 67 , 68 , 74 ] ( Figure 2 g).…”

Section: Resultsmentioning

confidence: 99%

“…In eight studies, radiological examinations supplemented the evaluation of bone healing but were not used as the primary outcome, which was mucosal healing [ 37 , 38 , 39 , 55 , 57 , 60 , 68 , 70 ] ( Figure 2 l) ( Table S1 part B ).…”

Section: Resultsmentioning

confidence: 99%

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Reporting Criteria for Clinical Trials on Medication-Related Osteonecrosis of the Jaw (MRONJ): A Review and Recommendations

Gaudet

Odet

Meyer

et al. 2022

Cells

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Medication-related osteonecrosis of the jaw (MRONJ) is a complication caused by anti-resorptive agents and anti-angiogenesis drugs. Since we wanted to write a protocol for a randomized clinical trial (RCT), we reviewed the literature for the essential information needed to estimate the size of the active patient population and measure the effects of therapeutics. At the same time, we designed a questionnaire intended for clinicians to collect detailed information about their practices. Twelve essential criteria and seven additional items were identified and compiled from 43 selected articles. Some of these criteria were incorporated in the questionnaire coupled with data on clinical practices. Our review found extensive missing data and a lack of consensus. For example, the success rate often combined MRONJ stages, diseases, and drug treatments. The occurrence date and evaluation methods were not harmonized or quantitative enough. The primary and secondary endpoints, failure definition, and date coupled to bone measurements were not well established. This information is critical for writing a RCT protocol. With this review article, we aim to encourage authors to contribute all their findings in the field to bridge the current knowledge gap and provide a stronger database for the coming years.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Reporting Criteria for Clinical Trials on Medication-Related Osteonecrosis of the Jaw (MRONJ): A Review and Recommendations

Gaudet

Odet

Meyer

et al. 2022

Cells

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“…In a retrospective study, the incidence of BP-related ONJ in patients with multiple myeloma and breast cancer was higher than that in patients with prostate cancer, lung cancer, kidney cancer, and other tumors ( 12 ). To be diagnosed with ONJ, a patient must meet the following criteria proposed by the American Association of Oral and Maxillofacial Surgeons (AAOMS): (I) a persistently nonhealing mandible or maxillary bone for longer than 8 weeks, (II) treatment with antiresorptive agents and/or antiangiogenesis, (III) no history of previous radiation to this region, and (IV) no tumor invasion or metastasis in this site ( 13 , 15 , 16 ).…”

Section: Discussionmentioning

confidence: 99%

Unexpected massive bleeding caused by extensive maxillary osteonecrosis in a breast cancer patient: a case report

Liu¹,

Ma²,

Liu³

et al. 2021

Transl Cancer Res TCR

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Diphosphonate application is routinely recommended to treat bone metastasis (BM) in cancer patients. However, the severe side effects of diphosphonate, especially after long-term use, are often overlooked by clinicians. In this article, we describe a case in which a heavily-treated breast cancer patient, suffered from massive bleeding as a result of maxillary osteonecrosis by zoledronic acid (ZA) and apatinib.In October 2018, a 48-year-old Chinese female with breast cancer presented at our department with brain metastases. The patient had experienced progression multiple times and had received several lines of systemic interventions. ZA was administered monthly for a rather long period of 37 months. She also took 250 mg of apatinib, a small molecular tyrosine kinase inhibitor (TKI) that targets vascular endothelial growth factor receptor 2, daily for 11 days. However, massive bleeding from the oral and nasal cavity occurred that could not be alleviated by conventional means. Computed tomography revealed severe destruction and loss of the right maxillary bone and maxillary sinus wall. A pathological examination of the exfoliated bone tissue further confirmed that the patient was suffering from necrosis rather than metastasis. An emergency interventional embolization was performed, and the bleeding was stopped. In this case, maxillary osteonecrosis developed from the antiresorptive agents. Antiangiogenesis drugs should be avoided whenever possible. In clinical practice, the high risk of osteonecrosis needs to be carefully considered. Further, care needs to be taken to ensure osteonecrosis is not misdiagnosed as BM, especially in stage IV patients. Pathology is a prerequisite for the timely and correct diagnosis and management. Life-threatening toxicity such as massive bleeding, should be avoided to ensure that patients receive adequate antitumor treatments.

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“…La AAOMS sugiere que las recomendaciones y cuidados se enfoquen en base al estadío de la lesión. (Altay M et al, 2020) En casos de pacientes en los que es inevitable una intervención quirúrgica se recomienda utilizar profilaxis antibiótica de amoxicilina más ácido clavulánico, alisado de rebordes y cierre de la herida, uso de enjuagues bucales, así como el uso de fibrina rica en leucocitos y plaquetas, lo cual mostró una reducción del riesgo de osteonecrosis. (Coropciuc et al, 2023) Otro estudio sugiere la administración de N-acetil-cisteína (NAC), metilxantina, pentoxifilina o tocoferol puede favorecer la cicatrización en estudio con roedores.…”

Section: Manejo Odontológicounclassified

Osteonecrosis como complicación postquirúrgica en cirugía oral en pacientes sometidos a tratamientos con antirresortivos. Revisión integrativa

Correa

Alvarez

Calle

2023

RSD

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En la actualidad la administración de medicamentos antirresortivos para el tratamiento de diferentes padecimientos relacionados con el tejido óseo, ha ido en aumento. Sin embargo, también pueden desencadenar complicaciones que nosotros como profesionales de la salud debemos conocer. Hoy en día existe mucha información acerca del tema por esto, es importante que tengamos información más relevante y concreta de fácil comprensión para un odontólogo de práctica general para detectar esta afectación tempranamente, valorando los riesgos y beneficios que conllevan dichos tratamientos, el objetivo de la presente revisión es realizar una síntesis comprensible de los aspectos más importantes sobre osteonecrosis mandibular relacionada con fármacos antirresortivos y los cuidados a tenerse en cuenta. Se realizó una búsqueda minuciosa en diferentes bases de datos: Pubmed, EBSCO, Science Direct, Scopus, Scielo. Siendo incluídos 27 artículos a partir del 2019, 1 arículo base, 1 guía clínica y 1 libro para la presente revisión. La osteonecrosis es una complicación que puede aparecer posterior a la administración de medicamentos antirresortivos como los bifosnatos y denosumad utilizados en el tratamiento de enfermedades óseas, los administrados vía intravenosa han sido reportados mayormente con el desarrollo de ésta complicación, entre los factores de riesgo local desencadenantes predominan las exodoncias. El abordaje multidiciplinario es fundamental para el reconocimiento temprano de los pacientes predisponentes, brindando una atención oportuna y preventiva para disminuir así la gravedad de ésta complicación.

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Medication-related osteonecrosis of the jaw: An institution’s experience

Cited by 6 publications

References 25 publications

Reporting Criteria for Clinical Trials on Medication-Related Osteonecrosis of the Jaw (MRONJ): A Review and Recommendations

Reporting Criteria for Clinical Trials on Medication-Related Osteonecrosis of the Jaw (MRONJ): A Review and Recommendations

Unexpected massive bleeding caused by extensive maxillary osteonecrosis in a breast cancer patient: a case report

Osteonecrosis como complicación postquirúrgica en cirugía oral en pacientes sometidos a tratamientos con antirresortivos. Revisión integrativa

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