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
...Diagnosi...
...commended that the term “medication-...
Clinicians should confirm the presence...
Risk Reduction
...Risk Reduction...
...CareFor cancer patients scheduled to recei...
...e Risk FactorsMembers of the multidis...
...alveolar SurgeryElective dentoalveolar s...
...Surgery Follow-UpIf dentoalveolar surgery...
...y Discontinuation of BMAs Prior to...
Staging
...Staging...
...hed staging system should be used...
...staging should be performed by a clinician exper...
Treatment
...al Treatment of MRONJConservative meas...
...of Refractory MRONJAggressive surgical interven...
...ontinuation of BMAsFor patients diagnosed wi...
...asuresDuring the course of MRONJ treatment, the...
...and Risk of MRONJ Medic...
...ed Terms to Characterize ONJ After Treatmen...
...Descriptions of Complete, Partial and Minimal De...
.../ISOO Daily Oral Care Plan for Patients...
...ble 5. Treatment Strategies by Sta...
...RONJ Management Flow Diagra...
...Consider conti...