Positionspapier zur medikamentenassoziierten Osteonekrose des Kiefers (MRONJ)

Svejda, Bernhard; Muschitz, Ch.; Gruber, Reinhard; Brandtner, C. E.; Svejda, Ch.; Gasser, R.; Santler, Gert; Dimai, Hans Peter

doi:10.1007/s00715-015-0064-3

Cited by 10 publications

(16 citation statements)

References 27 publications

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“…It has been estimated that the prevalence of antiresorptive agent-related ONJ (ARONJ) in osteoporosis patients ranges from 0.001 to 0.01% in Australia, Canada, Germany, the USA, and Sweden. It has been reported that the prevalence of BRONJ in osteoporosis patients taking oral bisphosphonates ranges 0% to 0.04%, although it is usually less than 0.001% [2,9,[13][14][15]. However, there have been limited data on the prevalence of DRONJ.…”

Section: Low-dose Bisphosphonate and Denosumab Users With Osteoporosismentioning

confidence: 99%

“…Therefore, current treatment strategies for MRONJ have been constructed based on clinical aspects rather than scientific data. In this section, the treatment strategy for MRONJ at each stage is introduced based on several position papers [1,14,30,35], a clinical guideline [10], and other studies including systematic reviews and consensus statements by the International Task Force on ONJ [2,9,26,41,59].…”

Section: Treatment Strategies For Mronjmentioning

confidence: 99%

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Clinical considerations for medication-related osteonecrosis of the jaw: a comprehensive literature review

2021

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Background Medication-related osteonecrosis of the jaw (MRONJ), which was first reported as bisphosphonate-related osteonecrosis of the jaw (BRONJ) in bisphosphonate users, is a rare but severe soft and hard tissue disease induced by several types of medications. There has been a deluge of information about MRONJ, such as epidemiology, risk factors, clinical recommendations for dental treatment to prevent it, and treatment strategies in medication-prescribed users. The aim of this study was to comprehensively review recent articles and provide the current scientific information about MRONJ, especially clinical considerations or recommendations for dental treatment to prevent its occurrence. Materials and methods The current literature review was mainly based on 14 systematic reviews with or without meta-analysis, 4 position papers, 1 consensus statement, 1 clinical guideline, and 2 clinical reviews regarding MRONJ after a PubMed database and manual searches according to inclusion and exclusion criteria. Moreover, 53 articles were selected by manual search in regard to all references from selected articles and other articles identified on the PubMed search, irrespective of publication date, and inclusion and exclusion criteria. Results The incidence and prevalence of MRONJ are relatively low, although they are clearly higher in cancer patients receiving high-dose antiresorptive agents or angiogenesis inhibitors rather than osteoporosis patients receiving oral bisphosphonates or denosumab. There are many types of local, systemic, and other risk factors for the development of MRONJ. Clinical recommendations are provided for each clinical situation of patients to prevent MRONJ. There are also treatment strategies for MRONJ in each stage. Conclusions General dentists should perform appropriate dental treatment to prevent MRONJ in the patients prior to or when receiving medications that could induce MRONJ. Moreover, there are treatment strategies for MRONJ in each stage that oral surgeons could follow. Adequate and updated clinical information regarding MRONJ based on scientific data is required whenever possible.

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Section: Low-dose Bisphosphonate and Denosumab Users With Osteoporosismentioning

confidence: 99%

Section: Treatment Strategies For Mronjmentioning

confidence: 99%

Clinical considerations for medication-related osteonecrosis of the jaw: a comprehensive literature review

2021

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“…Furthermore, radiation protection is an issue when it comes to determining which modality is necessary when and how often progress controls are useful. As a result of this discussion, many international guidelines do not give clear recommendations but leave the decision open to the practitioner (Di Fede et al, 2018;Schiegnitz et al, 2018;Schiodt et al, 2019;Svejda et al, 2016;Yoneda et al, 2017).…”

Section: Soundia Et Al Used Opt and Cbct Images Of 23 Patients Of Stagementioning

confidence: 99%

Diagnostic accuracy comparing OPT and CBCT in the detection of non‐vital bone changes before tooth extractions in patients with antiresorptive intake

et al. 2021

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Objectives: To compare the diagnostic accuracy in detecting early non-vital bone changes between orthopantomography (OPT) and cone-beam computed tomography (CBCT) in correlation with histopathological findings before tooth extractions in patients with antiresorptive (AR) intake. Subjects:Patients with an indication tooth extraction who had received OPT and CBCT preoperatively while or after undergoing AR treatment were prospectively enrolled over a 24-month period in the progesterone in spontaneous miscarriage (PRISM) trial. Imaging studies were randomly analyzed by three examiners for early non-vital bone changes using specific predefined characteristics and a 5-level scale (1 definite absence of criteria to 5 definite presence of criteria). Sensitivity and specificity values were calculated in correlation with the histopathologically evaluated bone samples at the time point of tooth extraction. Results:One hundred thirty patients with 237 treated extraction sites met the inclusion criteria. For all images evaluated by all examiners, CBCT (430/492; 87.4%; receiver operating characteristic [ROC]: area under the curve [AUC] = 0.88; p < 0.001) was more likely to detect histopathologically confirmed non-vital bone than the OPT (132/492; 26.8%; ROC: AUC = 0.562; p = 0.115). Conclusions:In the detection of non-vital bone changes, CBCT is superior to OPT in both sensitivity and specificity. Specific imaging characteristics allow for the prediction of early non-vital bone changes already at the time before tooth extractions.

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“…As terapias com antibióticos devem ser tomadas, apenas se necessário e por curtas durações (A. Khan et al, 2016;Svejda et al, 2016).…”

Section: Tratamento Da Osteonecrose Induzida Por Medicamentosunclassified

Osteonecrose dos maxilares induzidas por medicamentos: como prevenir e tratar

Fernandes

Lopes

Rodrigues

et al. 2022

RSD

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As drogas ósseas específicas (BSDs) atuam de forma fundamental no tratamento de indivíduos com baixar densidade óssea mineral, fraturas ou metástase óssea. Elas podem ser classificadas como antirreabsotivos ou anabólicos. O ONJ foi associado pela primeira vez ao tratamento com bisfosfonatos em 2003, e agora é amplamente reconhecido como um efeito adverso do tratamento com bisfosfonatos e outros BSD. Nesse sentido, este estudo objetivou revisar a literatura acerca da osteonecrose dos maxilares induzidas pelo uso de medicamentos, abordando os métodos de diagnóstico, bem como os protocolos de prevenção e tratamento dessa doença. Para a construção deste artigo foi realizado um levantamento bibliográfico nas bases de dados SciVerse Scopus, Scientific Eletronic Library Online (Scielo), U.S. National Library of Medicine (PUBMED) e ScienceDirect, com auxílio do gerenciador de referências Mendeley. Os artigos foram contemplados entre os anos de 2010 a 2022. A osteonecrose dos maxilares induzidas por medicamentos é uma consequência adversa incomum, mas potencialmente muito séria, da terapia medicamentosa para PB. Está principalmente associado ao uso de amino-bifosfonatos mais potentes por longos períodos de tempo. O evento antecedente mais comum ao desenvolvimento de lesões clínicas é o tratamento odontológico invasivo, sendo, portanto, particularmente importante que os profissionais de saúde bucal tenham uma compreensão de suas causas e manejo. A prevenção continua sendo o aspecto mais importante do manejo e começa no momento da primeira prescrição e deve continuar pelo resto da vida do paciente devido ao efeito duradouro desses medicamentos no osso.

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Positionspapier zur medikamentenassoziierten Osteonekrose des Kiefers (MRONJ)

Cited by 10 publications

References 27 publications

Clinical considerations for medication-related osteonecrosis of the jaw: a comprehensive literature review

Clinical considerations for medication-related osteonecrosis of the jaw: a comprehensive literature review

Diagnostic accuracy comparing OPT and CBCT in the detection of non‐vital bone changes before tooth extractions in patients with antiresorptive intake

Osteonecrose dos maxilares induzidas por medicamentos: como prevenir e tratar

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