Osteonecrosis of the jaw: An update

Abstract

Introduction: Osteonecrosis of the jaw (ONJ) is a well-known pathological condition in oncology arising from bisphosphonate use. In recent years, the number of cases of drug-related osteonecrosis of the jaw has steadily increased due to the introduction of new immunological drugs. Objective: To analyze the literature on osteonecrosis of the jaw and its relation to drugs. Methodology: The search was performed in PubMed, SCOPUS and Google Scholar databases. The quality of the articles was assessed using PRISMA guidelines. The terms "osteonecrosis jaw", "etiology", "epidemiology", "diagnostic methods", "oral manifestations", "treatment", in conjunction with logical Boolean operators AND, OR and NOT were used. Results: Although the pathogenesis of ONJ is still unclear, genetic factors have shown an important role in this disease. It is more frequent in patients who ingest bisphosphonates, whether orally or intravenously, with a frequency of 65% in the mandible. Necrotic bone exposure is one of the most frequent oral manifestations that occur. The most characteristic diagnostic methods include orthopantomography, magnetic resonance imaging and computed tomography. One of the treatments to consider is the education and instruction in oral hygiene that the patient should perform/take, as well as the use of oral antibacterial rinses. Conclusion: Every patient treated with bisphosphonates is susceptible to present mandibular osteonecrosis when undergoing invasive dental procedures, therefore, it is necessary to consider which are the most significant clinical characteristics, as well as the diagnostic methods by which we can identify it in the patient; the treatments are very varied depending on the situation in which each case is found.

Assessment of Quality of Life in Patients with Medication-Related Osteonecrosis of the Jaw Following Reconstructive and Restorative Surgery

“…In particular, the exposure of bone tissue after removal is regarded as exostosis, a sharp edge of the socket, etc. Attempts to eliminate this condition using traditional methods of surgical treatment can aggravate the course of osteonecrosis, leading to an acceleration in its spread, a deterioration in the patient's quality of life, and a deterioration in the prognosis of the disease [9,10].…”