Medication-related osteonecrosis of the jaws (MRONJ) in cancer patients treated with denosumab VS. zoledronic acid: A systematic review and meta-analysis

Limones, Álvaro; Sáez-Alcaide, Luis Miguel; Angulo‐Díaz‐Parreño, Santiago; Helm, Alexandra; Bornstein, Michael M.; Molinero‐Mourelle, Pedro

doi:10.4317/medoral.23324

Cited by 95 publications

(103 citation statements)

References 36 publications

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“…Analyzing Limones A. et al's meta-analysis, no significant clinical differences were found concerning bone necrosis associated with BPs versus DS, coinciding with our experience [11].…”

Section: Oncology Patientsupporting

confidence: 89%

“…According to the recommendations of AAOMS [2], Task Force [12] and AOCMF [3] coincide with the sharing of consensus on minimally invasive manipulations once the necrotic foci have been installed and the preventive attitude prevails of eliminating all septic foci prophylactically before starting therapy with antiresorptive drugs. There are positions with a trend more committed to direct bone manipulation to evacuate the infectious problem [11] and other more conservative positions to not expand drug necrosis volumetrically due to bone accumulation of BPs or DS [3].…”

Section: Oncology Patientmentioning

confidence: 99%

“…Access to the hyperbaric chamber only affects antiangiogenic recovery, but therapeutic success has not been proven in patients with MRONJ. There are not enough studies to support such therapies [1][2][3][4][5][6][7][8][9][10][11][12][13][14].…”

Section: Oncology Patientmentioning

confidence: 99%

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Clinical management of maxillary osteonecrosis associated with antiresorptive medication (MRONJ): Presentation of clinical cases

Rey¹,

Genta

Picardo

2020

jimsa

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Antiresorptive drugs: Bisphosphonates (BPs) and Monoclonal Antibodies: Denosumab (DS) are known to suppress osteoclastic activity, affecting the expression of the RANKL (Kappa β Nuclear Activation Receptor), which corresponds to an osteoblastic differentiation factor and which is secreted by said cells, being responsible for inducing reabsorption by osteoclasts. Under certain circumstances, those medications may induce the development of Maxillary Osteonecrosis (MRONJ).The paper is aimed to share our experience of MRONJ treatment using minimally invasive therapies (including washes and antibiotics) that does not expand the necrotic bed volumetrically and provide non-recurrent resolution of the lesion. The patients we described were on long-term therapy either with BPs or DS.Conclusion: Interaction between health professional is essential for MRONJ prevention. The therapeutics consolidated in non-invasive maneuvers, and the manipulation of bone tissue with close follow up allows to avoid spread to deep planes. The pathological process could be successfully treated, and it is not necessary to suspend antiresorptive medications.

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“…Analyzing Limones A. et al's meta-analysis, no significant clinical differences were found concerning bone necrosis associated with BPs versus DS, coinciding with our experience [11].…”

Section: Oncology Patientsupporting

confidence: 89%

Section: Oncology Patientmentioning

confidence: 99%

See 1 more Smart Citation

Clinical management of maxillary osteonecrosis associated with antiresorptive medication (MRONJ): Presentation of clinical cases

Rey¹,

Genta

Picardo

2020

jimsa

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“…41 Invasive dental procedure is a widely analyzed risk factor for ONJ, 42 suggesting that medication guidance and timely prevention should be applied. A recently published metaanalysis 43 of the prevalence of medication-related ONJ in patients with cancer reported that denosumab was associated with a significantly higher risk for ONJ than was ZA. The quantitative analysis was based on data from 6 RCTs but included the overall results from a clinical trial and subgroup analysis results from the same study, which may have accounted for the differences in outcomes.…”

Section: Discussionmentioning

confidence: 99%

Denosumab Versus Zoledronic Acid in the Prevention of Skeletal-related Events in Vulnerable Cancer Patients: A Meta-analysis of Randomized, Controlled Trials

Chen

Yang

et al. 2020

Clinical Therapeutics

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“…The condition in which diagnosis of osteonecrosis of the jaws has been made by a dentist or medical doctor. [48] Dry mouth The condition in which the salivary glands in the mouth do not make enough saliva to keep the mouth wet. [49] Abnormal tongue shape and color…”

Section: Impaired Verbal Communicationmentioning

confidence: 99%

Proposal of Dental Hygiene Diagnosis for Cancer Patients Based on Dental Hygiene Process of Care in Acute Care Hospitals: A Narrative Review

Matsuda¹,

Karino²,

Okuma³

et al. 2020

Healthcare

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A narrative review was conducted to propose dental hygiene diagnoses for cancer patients based on dental hygiene process of care in acute care hospitals. Six researchers, including three dental hygienists, all with expertise in oral healthcare for patients with cancer, decided the review outline. All researchers reviewed the literature and developed terminology for dental hygiene diagnoses. The team then modified the terminology and discussed its clarity and acceptability to develop an initial list of dental hygiene diagnosis names according to the dental hygiene human needs conceptual model subscales. In wholesome facial image, one new diagnosis was developed. In protection from health risks, 15 new diagnoses were developed. In biologically sound and functional dentition, 10 new diagnoses were developed. In skin and mucous membrane integrity of the head and neck, 10 new diagnoses were developed. In freedom from head and neck pain, two new diagnoses were developed. In freedom from anxiety and stress, eight new diagnoses were developed. In responsibility for oral health, five new diagnoses were developed. In conceptualization and understanding, three new diagnoses were developed. Based on this study, it is necessary for the academic community to develop a better taxonomy of dental hygiene diagnoses pertaining to dental hygienist clinical practice.

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Medication-related osteonecrosis of the jaws (MRONJ) in cancer patients treated with denosumab VS. zoledronic acid: A systematic review and meta-analysis

Cited by 95 publications

References 36 publications

Clinical management of maxillary osteonecrosis associated with antiresorptive medication (MRONJ): Presentation of clinical cases

Clinical management of maxillary osteonecrosis associated with antiresorptive medication (MRONJ): Presentation of clinical cases

Denosumab Versus Zoledronic Acid in the Prevention of Skeletal-related Events in Vulnerable Cancer Patients: A Meta-analysis of Randomized, Controlled Trials

Proposal of Dental Hygiene Diagnosis for Cancer Patients Based on Dental Hygiene Process of Care in Acute Care Hospitals: A Narrative Review

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