Review of: "Italian Position Paper (SIPMO-SICMF) on Medication-Related Osteonecrosis of the Jaw (MRONJ) (original) (raw)

Italian Position Paper (SIPMO-SICMF) on Medication-Related Osteonecrosis of the Jaw (MRONJ)

Despite being one of the most recently studied oral diseases, MRONJ remains a condition with uncertain and controversial issues. The aim of this updated version of the position paper on MRONJ developed by the Italian Societies of Oral Pathology and Medicine (SIPMO) and of Maxillofacial Surgery (SICMF) is to set forth an original interpretation of the current disputes on MRONJ. The Expert panel was appointed by the SIPMO and SICMF Board of Trustees in 2010 and comprised a multidisciplinary group of clinicians and researchers with recognized expertise in the field, who tracked the available literature and released two consecutive sets of Italian recommendations on MRONJ in 2013 and 2020. The advance of scientific knowledge and the perceived need for refinements to the previous position papers were recognized by the board panel who approved the submission of this updated version. This position paper highlights the current research status and provides a different perspective on several ...

18 Years of Medication-Related Osteonecrosis of the Jaw (MRONJ) Research: Where Are We Now?—An Umbrella Review

Applied Sciences

Background: Osteonecrosis of the jaw (ONJ) is a condition affecting patients exposed to medications used to treat benign and malignant conditions of bone tissue. Many studies have highlighted that ONJ is a severe condition, which is very challenging to manage, especially in individuals with oncologic disease. The aim of this umbrella review is to analyze all available interventional and non-interventional systematic reviews published on medication-related osteonecrosis of the jaw (MRONJ) and summarize this evidence. Material and methods: A multi-database search (PubMed, MEDLINE, EMBASE and CINAHL) was performed to identify related multi-language papers published from January 2003 until June 2021. An additional manual search was also performed in systematic review registries (PROSPERO, INPLASY, JBI and OFS) to identify possible missing reviews. Data were extracted from relevant papers and analyzed according to the outcomes selected in this review. Results: The search generated 25 sys...

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

International Journal of Implant Dentistry, 2021

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 an...

A Review On Medication-Related Osteonecrosis Of The Jaw: Definition and Best Practice For Prevention, Diagnosis, and Treatment

SciDoc Publishers, 2021

The aim is to review on medication related osteonecrosis of the jaw its definition, prevention, diagnosis and treatment. Skeletal complications due to osteoporosis or bone metastases are associated with considerable pain, increased mortality, and reduced quality of life. Agents that prevent bone resorption such as bisphosphonates or denosumab can reduce the risk of skeletalrelated events and are widely used in patients with osteoporosis or bone metastases. 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. 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.

Medication-Related Osteonecrosis of Jaws (MRONJ) Prevention and Diagnosis: Italian Consensus Update 2020

International Journal of Environmental Research and Public Health

The Medication-Related Osteonecrosis of Jaws (MRONJ) diagnosis process and its prevention play a role of great and rising importance, not only on the Quality of Life (QoL) of patients, but also on the decision-making process by the majority of dentists and oral surgeons involved in MRONJ prevention (primary and secondary). The present paper reports the update of the conclusions from the Consensus Conference—held at the Symposium of the Italian Society of Oral Pathology and Medicine (SIPMO) (20 October 2018, Ancona, Italy)—after the newest recommendations (2020) on MRONJ were published by two scientific societies (Italian Societies of Maxillofacial Surgery and Oral Pathology and Medicine, SICMF and SIPMO), written on the inputs of the experts of the Italian Allied Committee on ONJ (IAC-ONJ). The conference focused on the topic of MRONJ, and in particular on the common practices at risk of inappropriateness in MRONJ diagnosis and therapy, as well as on MRONJ prevention and the dental ...

Treatment of medication-related osteonecrosis of the jaw (MRONJ). A systematic review

PubMed, 2021

Objective: Medication-related osteonecrosis of the jaw (MRONJ) is a severe drug-related side effect mostly seen in the maxillofacial region of patients under current or previous treatment with antiresorptive and/or angiogenic agents. There is a wide range of treatment options explained in literature for the management of this condition, from conservative treatments to surgical procedures of various levels of invasiveness, which are sometimes supplemented with adjunctive therapies. The present systematic review aimed at evaluating the treatment options of MRONJ in terms of successful outcomes. Materials and methods: Medline, Scopus, and Cochrane databases were searched. The search was limited to clinical studies involving human subjects with at least 3 cases. There was no other limitation for language, publication date, and study design for the articles to be included. A hand search of the bibliographies of identified articles was also performed. The evaluation criterion was an improvement in the healing of the treated site after treatment procedures. Results: After evaluation of the full text of the articles, 118 articles were selected for evaluation (15 platelet concentrates, 4 teriparatide, 10 laser therapy, 3 hyperbaric oxygen, 2 ozone applications, 9 conservative protocols, and 75 surgical interventions articles). The evaluated articles reported positive improvements in healing/staging of the osteonecrosis sites. Conclusions: Due to the low evidence level and the limited sample size of the studies included, the results of this review must be cautiously interpreted. However, they can be suggestive for evaluating the possible benefits of these treatment options in MRONJ management. Further prospective comparative studies with a large sample size are urgently needed to confirm the results.

Osteonecrosis of the jaw related to non-antiresorptive medications: a systematic review

Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2018

The reporting of osteonecrosis of the jaw (ONJ) related to anticancer agents without known antiresorptive properties (non-antiresorptives), such as antiangiogenics, tyrosine kinase inhibitors, mammalian target of rapamycin inhibitors, immune checkpoint inhibitors, and cytotoxic chemotherapy is increasing. To review characteristics of ONJ in cancer patients receiving non-antiresorptives. A systematic review of the literature between 2009 and 2017 was conducted by the Bone Study Group of MASCC/ISOO. Of 6249 articles reviewed and from personal communication, 42 ONJ cases related to non-antiresorptives were identified. No gender predilection was noted. Median age was 60 years and ONJ stage 2 was most common, with predilection for posterior mandible. Exposed bone, pain, and infection were common at diagnosis. In comparison to bone targeting agents (BTAs), radiology, histology, and management were similar, with medication often discontinued. Delayed diagnosis (median 8 weeks) was noted. I...