Medication-Related Osteonecrosis of the Jaw
Key Points
Key Points
The condition may involve the mandible or the maxilla.
BMAs that have been linked with MRONJ principally include bisphosphonates and denosumab.
BMAs are a key component of the management of patients with cancer with skeletal metastases.
These medications provide a number of clinical benefits, including a reduced incidence of skeletal-related events (e.g., pathologic fractures and spinal cord compression) and reduced need for radiation or surgery to bone.
Use of BMAs is associated with MRONJ, which occurs in approximately 1–9% of patients with advanced cancer.
This pocket guide focuses on the prevention and management of MRONJ in patients with cancer who receive BMAs for oncologic indications.
The pocket guide does not address BMAs used for osteoporosis, which are administered at a lower dose and carry a lower risk for MRONJ, nor does the pocket guide address the prevention or management of MRONJ due to medications other than BMAs.
Diagnosis
...gnosis
It is recommended that the term “medication-...
...s should confirm the presence of all...
Risk Reduction
...isk Reducti...
...tion of CareFor cancer patients sc...
...FactorsMembers of the multidisciplinary...
...ive Dentoalveolar SurgeryElective dentoalveolar su...
...eolar Surgery Follow-UpIf dentoalveolar...
...orary Discontinuation of BMAs Prior to Dento...
Staging
Staging
...lished staging system should be used to q...
Optimally, staging should be performed b...
Treatment
...reatment...
...nitial Treatment of MRONJConservative measure...
...tment of Refractory MRONJAggressive surgical int...
...emporary Discontinuation of BMAsFor patien...
...me MeasuresDuring the course of MR...
.... BMAs and Risk of MRONJHaving trou...
...ble 2. Proposed Terms to Characterize O...
...ble 3. Descriptions of Complete, Partial and Min...
...SOO Daily Oral Care Plan for PatientsHaving tro...
...5. Treatment Strategies by Stage of MRONJaHaving...
...anagement Flow Diagram...
...Consider continuatio...