Medication-related osteonecrosis of the jaw: definition and best practice for prevention, diagnosis, and treatment

Publication date: Available online 9 October 2018

Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology

Author(s): Ourania Nicolatou-Galitis, Morten Schiødt, Rui Amaral Mendes, Carla Ripamonti, Sally Hope, Lawrence Drudge-Coates, Daniela Niepel, Tim Van den Wyngaert

Abstract

Skeletal complications due to osteoporosis or bone metastases are associated with considerable pain, increased mortality, and reduced quality of life. Furthermore, such events place a burden on healthcare resources. Agents that prevent bone resorption such as bisphosphonates or denosumab can reduce the risk of skeletal-related events and are widely used in patients with osteoporosis or bone metastases. Medication-related osteonecrosis of the jaw (MRONJ) is a rare but potentially serious adverse event associated with high cumulative doses of bisphosphonates or denosumab. However, MRONJ can be treated and the likelihood of developing this condition can be reduced through prophylactic dental care and the maintenance of good oral hygiene. Dentists have a critical role in preventing MRONJ as part of a multi-professional team. This review describes the incidence and pathophysiology of MRONJ and provide guidance for dental practitioners on the screening, prophylactic treatment, diagnosis, and management of patients with this condition.

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