Medication related osteonecrosis of jaw – A medical oncologist’s perspective

Abstract

Medication related osteonecrosis of jaw (MRONJ) is a rare iatrogenic disease. Cancer therapeutics is advancing exponentially and apart from a major emphasis on quality of life (QoL) in metastatic patients, now we are foreseeing increased longevity. This necessitates the rising need of betterment of supportive care modalities and looking into the rare complications of therapy. Bisphosphonates (BPs) and Denosumab, the anti-resorptive agents (ARAs) used commonly by medical oncologists in cancers with bone metastases and less commonly in prevention or treatment of osteoporosis, are implicated in the etiology of MRONJ. Many a times, it goes undetected, underdiagnosed and untreated due to lack of awareness, low index of suspicion and paucity of understanding of this disorder amongst medical oncology fraternity. A high index of suspicion is a cornerstone of timely diagnosis and therapeutic action. A regular collaboration between treating oncologist and dentist is of utmost importance.