Abstract
Antiresorptive therapy is the main form of prevention of osteoporotic or fragility fractures. Medication-related osteonecrosis of the jaw (MRONJ) is a relatively rare but severe adverse reaction to antiresorptive and antiangiogenic drugs. Physicians and dentists caring for patients taking these drugs and requiring invasive procedures face a difficult decision because of the potential risk of MRONJ. The aim of this study was to discuss the risk factors for the development of MRONJ and prevention of this complication in patients with osteoporosis taking antiresorptive drugs and requiring invasive dental treatment. For this goal, a task force with representatives from three professional associations was appointed to review the pertinent literature and discuss systemic and local risk factors, prevention of MRONJ in patients with osteoporosis, and management of established MRONJ. Although scarce evidence links the use of antiresorptive agents in the context of osteoporosis to the development of MRONJ, these agents are considered a risk factor for this complication. Despite the rare reports of MRONJ in patients with osteoporosis, the severity of symptoms and impact of MRONJ in the patients' quality of life make it imperative for health care professionals to consider this complication when planning invasive dental procedures.
Highlights
The management of patients with osteoporosis taking antiresorptive drugs is challenging
A need has arisen for a position paper involving health care professionals who assist patients with osteoporosis treated with antiresorptive drugs requiring dental care
Osteoporosis is a highly prevalent disease resulting in fragility fractures that reduce quality of life and increase the risk of death
Summary
Federal de São Paulo, São Paulo, SP, Brasil https://orcid.org/000-0003-0070-0640. Odontologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brasil 8 Divisão de Reumatologia, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil 9 Departamento de Medicina Clínica, Universidade Federal do Ceará, Fortaleza, CE, Brasil 10 Faculdade de Medicina, Centro. 12 Divisão de Endocrinologia, Santa Casa de Belo Horizonte, Bruno Ferraz-de-Souza https://orcid.org/0000-0003-4863-2544. Belo Horizonte, MG, Brasil 13 Laboratório de Endocrinologia Celular e Molecular (LIM-25) e Unidade de Doenças Osteometabólicas, Divisão de Endocrinologia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil. 14 Divisão de Endocrinologia e Diabetes, Faculdade de Medicina da Universidade de Pernambuco, Recife, PE, Brasil
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