Medication-Related Osteonecrosis of the Jaw: A Critical Narrative Review.

Alejandro I Lorenzo-Pouso,María Ángeles Blanco-Fernández,Cintia M Chamorro-Petronacci,Mario Pérez-Sayáns,Javier Carballo,José Bagán,Pablo Castelo-Baz,Leticia Bagán,Andrés Blanco-Carrión,Pilar Gándara-Vila,Óscar Álvarez-Calderón

doi:10.3390/jcm10194367

Abstract

Background: Nearly two decades have passed since a paradoxical reaction in the orofacial region to some bone modifying agents and other drugs was recognized, namely medication-related osteonecrosis of the jaw (MRONJ). Purpose: The aim of this manuscript was to critically review published data on MRONJ to provide an update on key terminology, concepts, and current trends in terms of prevention and diagnosis. In addition, our objective was to examine and evaluate the therapeutic options available for MRONJ. Methods: The authors perused the most relevant literature relating to MRONJ through a search in textbooks and published articles included in several databases for the years 2003–2021. Results and conclusions: A comprehensive update of the current understanding of these matters was elaborated, addressing these topics and identifying relevant gaps of knowledge. This review describes our updated view of the previous thematic blocks, highlights our current clinical directions, and emphasizes controversial aspects and barriers that may lead to extending the accumulating body of evidence related to this severe treatment sequela.

Highlights

Avascular necrosis, known as osteonecrosis, is a generic term referring to the ischemic death of the constituents of bone [1,2]
Osteonecrosis has a wide variety of causes and can affect nearly any bone in the human body, counterpart individually each osteonecrosis-affected bone has unique clinical, etiologic, and prognostic factors
Osteomyelitis of the jaw is a kind of avascular necrosis, characterized by infection and inflammation of the bone marrow in the bones of the jaw [5,6]

Summary

Introduction

Known as osteonecrosis, is a generic term referring to the ischemic death of the constituents of bone [1,2]. Two decades have passed since a paradoxical reaction in the orofacial region to some bone modifying agents and other drugs was recognized, namely medication-related osteonecrosis of the jaw (MRONJ). Purpose: The aim of this manuscript was to critically review published data on MRONJ to provide an update on key terminology, concepts, and current trends in terms of prevention and diagnosis. This review describes our updated view of the previous thematic blocks, highlights our current clinical directions, and emphasizes controversial aspects and barriers that may lead to extending the accumulating body of evidence related to this severe treatment sequela

Objectives

Methods

Findings

Conclusion