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10 pages, 257 KiB

Open AccessArticle

What Do Prescribers of Bone Modifying Agents Know about Medication-Related Osteonecrosis of the Jaw? Is Current Prevention Enough?

by Mihai Vlad Golu, Ionela Pașcanu, Cornelia Togănel, Cecilia Petrovan, Adina Cosarcă, Despina Luciana Bereczki Temistocle and Alina Ormenișan

Appl. Sci. 2022, 12(18), 9224; https://0-doi-org.brum.beds.ac.uk/10.3390/app12189224 - 14 Sep 2022

Cited by 2 | Viewed by 1120

Abstract

Osteonecrosis of the jaw represents interference by external and internal factors in the natural bone remodeling system. Numerous bone remodeling agents (BMAs), such as bisphosphonates, denosumab, and tyrosine kinase inhibitors, can lead to medication-related osteonecrosis of the jaw (MRONJ). This is a serious [...] Read more.

Osteonecrosis of the jaw represents interference by external and internal factors in the natural bone remodeling system. Numerous bone remodeling agents (BMAs), such as bisphosphonates, denosumab, and tyrosine kinase inhibitors, can lead to medication-related osteonecrosis of the jaw (MRONJ). This is a serious condition that ocurs as a side-effect of treatment in patients with osteoporosis or malignancies. Antiresorptive drugs are medications that target osteoclasts with the aim of preventing bone resorption and are used to treat osteoporosis, osteopenia, and a variety of other conditions, such as Paget’s disease. They are also used in cancer patients with active bone metastases where antiresorptive treatment is used for the prevention of skeletal complications. Poor dental health, infections, and especially dental surgery are the primary causes of MRONJ, while other risk factors, such as smoking, alcohol abuse, and diabetes mellitus, can also influence its development. Prevention is the key component of management, and thus awareness of the risk factors among prescribers is very important. The aim of our study was to evaluate current knowledge about MRONJ among BMA prescribers in an academic hospital and their awareness about oral health and dental check-ups. By using a custom-designed questionnaire addressed to general and internal medical practitioners, endocrinologists, rheumatologists, and oncologists as an instrument for collecting data, we tried to identify trends in BMA prescription among different specialists and their recommended preventative measures, with the aim of creating new strategies to prevent the occurrence of MRONJ. The survey revealed a low awareness among physicians of the potential risk factors and underlined the need for a concerted effort to improve patient management. In this sense, a multidisciplinary team approach that includes the patient, the drug prescriber, the dentist, and the oral surgeon could significantly improve the quality of life of patients with MRONJ. Full article

(This article belongs to the Special Issue Medication-Related Osteonecrosis of the Jaw: Prevention, Diagnosis and Treatment)

7 pages, 4475 KiB

Open AccessCommunication

Intraosseous Squamous Cell Carcinoma Associated with Denosumab-Induced Osteonecrosis of the Jaw

by Sandra Bacián Martínez, Carlos Navarro Cuéllar, Carlos Navarro Vila, Edurne Palacios Weiss, Roser Pujol Romanyá, Álvaro del Amo Fernández de Velasco, Margarita Escrig de Teijeiro, José Luis del Castillo Pardo de Vera, Irene Rodríguez Pérez, Arturo Sánchez-Pérez, José J. Zamorano-León, Antonio López-Farré, María Isabel García-Hidalgo Alonso and Ignacio Navarro Cuéllar

Appl. Sci. 2021, 11(16), 7646; https://0-doi-org.brum.beds.ac.uk/10.3390/app11167646 - 20 Aug 2021

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Abstract

Medication-related osteonecrosis of the jaw (MRONJ) has been associated with the use of different drugs administered in the treatment of malignant neoplasms or metastases and in antiresorptive therapies. Since 2010, denosumab, a monoclonal antibody whose mechanism of action is to prevent the activation [...] Read more.

Medication-related osteonecrosis of the jaw (MRONJ) has been associated with the use of different drugs administered in the treatment of malignant neoplasms or metastases and in antiresorptive therapies. Since 2010, denosumab, a monoclonal antibody whose mechanism of action is to prevent the activation of the RANK receptor on the surface of osteoclasts, has been associated with osteonecrosis of the jaw. Primary intraosseous squamous cell carcinoma (PIOSCC) is a rare neoplasm characterised by the presence of squamous cells within the maxillary or mandibular bone without an initial clinical association with the oral mucosa. We present a case of a PIOSCC in an osteonecrosis of the jaw related to a patient who received antiresorptive treatment with denosumab outlining the clinical and histopathological features of MRONJ and PIOSCC. Full article

(This article belongs to the Special Issue Medication-Related Osteonecrosis of the Jaw: Prevention, Diagnosis and Treatment)

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Review

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11 pages, 286 KiB

Open AccessReview

Current Trends in Adjuvant Therapies for Medication-Related Osteonecrosis of the Jaw

by Gyu-Jo Shim, Joo-Young Ohe, Young-Jae Yoon, Yong-Dae Kwon and Deog-Yoon Kim

Appl. Sci. 2022, 12(8), 4035; https://0-doi-org.brum.beds.ac.uk/10.3390/app12084035 - 16 Apr 2022

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Abstract

Medication-related osteonecrosis of the jaw (MRONJ) is a refractory disease, and a standard protocol for its treatment has not yet been established. In addition, owing to the old age of MRONJ patients and various complications, treatment goals focus on relieving the symptoms and [...] Read more.

Medication-related osteonecrosis of the jaw (MRONJ) is a refractory disease, and a standard protocol for its treatment has not yet been established. In addition, owing to the old age of MRONJ patients and various complications, treatment goals focus on relieving the symptoms and improving the quality of life. For this reason, different treatments such as conservative, surgical, and adjunctive treatments have been attempted. In particular, adjunctive treatment, which is effective for promoting healing and reducing recurrence, is gaining increasing interest, and several studies and clinical trials related to it have been published. Representative adjuvant therapies include teriparatide, recombinant human bone morphogenetic protein-2, hyperbaric oxygen, photobiomodulation and platelet concentrates. All have generally shown beneficial effects; however, no standard protocol for adjunctive treatment exists. Therefore, in this literature review, we briefly summarized the different adjuvant therapies and reviewed clinical reports to help decide whether to use adjuvant therapies in treating patients with MRONJ. Full article

(This article belongs to the Special Issue Medication-Related Osteonecrosis of the Jaw: Prevention, Diagnosis and Treatment)

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