Abstract
Simple SummaryMyeloma is a common cancer involving the bone marrow. Some of the medications used in the treatment of myeloma, including those that reduce the risk of bone fractures, can increase the chance of side effects occurring in the jawbone. The most serious complication in the jawbone is called medication-related osteonecrosis, meaning part of the jawbone dies. The aim of this review is to highlight some of the medications that are implicated and other risk factors that can contribute to osteonecrosis. Suggestions to prevent this complication from occurring are described. Conventional methods of treating established medication-related osteonecrosis of the jawbone are outlined as well as emerging new treatments.Myeloma is a common haematological malignancy in which adverse skeletal related events are frequently seen. Over recent years, treatment for myeloma has evolved leading to improved survival. Antiresorptive therapy is an important adjunct therapy to reduce the risk of bone fractures and to improve the quality of life for myeloma patients; however, this has the potential for unwanted side effects in the oral cavity and maxillofacial region. Osteonecrosis of the jaw related to antiresorptive medications and other myeloma therapies is not uncommon. This review serves to highlight the risk of osteonecrosis of the jaw for myeloma patients, with some suggestions for prevention and management.
Highlights
Medication-related osteonecrosis of the jaw (MRONJ) is an uncommon but insidious side effect of some medications used in the treatment of multiple myeloma (MM)
MRONJ is not a rare adverse event in myeloma patients; continuous monitoring and vigilance is essential from haemato-oncologists, and dental and oral maxillofacial specialists [2]
This review aims to summarise the mechanism of action of some of the common therapies used to treat myeloma and how these might impact the maxillofacial region
Summary
Medication-related osteonecrosis of the jaw (MRONJ) is an uncommon but insidious side effect of some medications used in the treatment of multiple myeloma (MM). MRONJ may occur spontaneously after exposure to bone modifying agents such as bisphosphonates or denosumab or more commonly following an invasive procedure such as dental extractions. It can cause serious functional disturbance, morbidity, and adversely impact quality of life [1]. MRONJ is not a rare adverse event in myeloma patients; continuous monitoring and vigilance is essential from haemato-oncologists, and dental and oral maxillofacial specialists [2]. As the survival of MM patients improves with the discovery and development of novel therapies, the incidence of MRONJ may rise as the duration of exposure to bone modifying agents increases. This review aims to summarise the mechanism of action of some of the common therapies used to treat myeloma and how these might impact the maxillofacial region
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