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.

Treatment of medication-related osteonecrosis of the jaw (MRONJ). A systematic review / F. Goker, E. Grecchi, F. Grecchi, L. Francetti, M. Del Fabbro. - In: EUROPEAN REVIEW FOR MEDICAL AND PHARMACOLOGICAL SCIENCES. - ISSN 1128-3602. - 25:6(2021), pp. 2662-2673. [10.26355/eurrev_202103_25430]

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

F. Goker
Primo
;
E. Grecchi
Secondo
;
L. Francetti
Penultimo
;
M. Del Fabbro
Ultimo
2021

Abstract

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.
Bisphosphonates; BRONJ; HBO; Laser therapy; MRONJ; MRONJ treatment; Oral surgery; Ozone therapy; Platelet concentrates; PTH
Settore MED/50 - Scienze Tecniche Mediche Applicate
Settore MED/28 - Malattie Odontostomatologiche
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/861148
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