“Dental Consideration in Patients Under Bisphosphonate and Radiotherapy: Systematic Review”

Abstract

Background: Medication-related osteonecrosis of the jaw is defined as the necrosis of jawbone cells in patients who are on drugs known to increase the risk of the disease. The condition may lead to several complications in oral cavity. Osteoradionecrosis is a serious complication of radiotherapy for head and neck cancer. Radioactive osteonecrosis most commonly occurs in the mouth during treatment of head and neck cancer and can appear up to 5 years after radiation. The aim of current systematic review was highlighted on the dental consideration after and during radiotherapy and treatment of bisphosphonate. Methodology: The present Systematic review conducted to relevant recent articles that detected and identified through the journals databases (PUBMED, EMBASE, and MEDLINE) between the year 01 January 2015 to 01 May 2022. A search was achieved by using the specific keywords terms Dental care; Dental management; bisphosphonate-related osteonecrosis of the jaw (BRONJ); Osteoradionecrosis; Bisphosphonate; and Radiotherapy. Results: The current systematic review conducted to 18 articles published after 2015s, most articles were highlighted on Head and neck cancer with low sample size, and osteonecrosis condition during Bisphosphate therapy. The results showed significant Osteoradionecrosis effect of radiotherapy on jawbone characterized by non-healing socket after extraction, loosening of teeth, exposed oral cavity bone, poor healing and infection of soft tissue, numbness, or the feeling of heaviness in the jaw and exudate discharge. As well as the results showed negative osteonecrosis effect of BP therapy on the jawbone during therapy characterized by change of tooth structure. Conclusion: HNC patients should have comprehensive dental examination before undergoing to radiotherapy, as well as clearance before start bisphosphates, also dentist Should be highly educated and skilled in managing oral disease and minimize the high risk of complications.