New paradigms for dental prevention of medication related osteonecrosis of jaws (MRONJ)

Abstract

ONJ-Prevention of local osteonecrosis risk factors should be planned before and during the intake of associated drugs, according to new schedules. Secondary prevention requires a careful clinical oral examination, but also first level X-ray examinations and, when necessary, second level (CT) too. Three main risk factors of ostonecrosis of the jaws (ONJ) are recognised: (i) the type of ONJ-related medications: antiresorptive (e.g., Bisphosphonates, Denosumab) and antiangiogenic drugs (e.g., Bevacizumab, Sunitinib); (ii) the category of patient at MRONJ risk: cancer versus non-cancer patient; (iii) the typologies and timing of dental treatments (e.g., before, during, or after the drug administration). The aim of the paper is to report and summarize the new paradigm recently published (https://www.hindawi.com/journals/bmri/2018/2684924/) by the Italian Society of Oral Pathology and Medicine (SIPMO) on preventive dental management in patients at risk of Medication related osteonecrosis of the jaw (MRONJ), prior to and during/after the administration of the aforementioned ONJ-related drugs.