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...
...is recommended that the term “medication-r...
...ld confirm the presence of all thre...
Risk Reduction
...sk Reducti...
...CareFor cancer patients scheduled to r...
...Risk FactorsMembers of the multidisciplinary...
...ctive Dentoalveolar SurgeryElective dentoalv...
...alveolar Surgery Follow-UpIf dentoalveolar surge...
...continuation of BMAs Prior to Dentoalveolar Surger...
Staging
...taging
A well-established staging system should...
Optimally, staging should be performed by a...
Treatment
...atment...
Initial Treatment of MRONJConservative measure...
...tment of Refractory MRONJAggressive...
...Discontinuation of BMAsFor patients diag...
...come MeasuresDuring the course of MRONJ trea...
...le 1. BMAs and Risk of MRONJHaving tro...
...2. Proposed Terms to Characterize O...
...3. Descriptions of Complete, Parti...
...CC/ISOO Daily Oral Care Plan for Pa...
Table 5. Treatment Strategies by Stage of...
...NJ Management Flow D...
...Consider continuation vs....