Pathogenesis and multidisciplinary management of medication-related osteonecrosis of the jaw

Int J Oral Sci. 2020 Oct 21;12(1):30. doi: 10.1038/s41368-020-00093-2.

Abstract

Medication-related osteonecrosis of the jaw (MRONJ) is a serious side effect of bone-modifying agents and inhibits angiogenesis agents. Although the pathogenesis of MRONJ is not entirely clear, multiple factors may be involved in specific microenvironments. The TGF-β1 signalling pathway may have a key role in the development of MRONJ. According to the clinical stage, multiple variables should be considered when selecting the most appropriate treatment. Therefore, the prevention and management of treatment of MRONJ should be conducted in patient-centred multidisciplinary team collaborative networks with oncologists, dentists and dental specialists. This would comprise a closed responsibility treatment loop with all benefits directed to the patient. Thus, in the present review, we aimed to summarise the pathogenesis, risk factors, imaging features, clinical staging, therapeutic methods, prevention and treatment strategies associated with MRONJ, which may provide a reference that can inform preventive strategies and improve the quality of life for patients in the future.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Bisphosphonate-Associated Osteonecrosis of the Jaw* / prevention & control
  • Bone Density Conservation Agents* / adverse effects
  • Humans
  • Quality of Life
  • Risk Factors

Substances

  • Bone Density Conservation Agents