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Medication-Related Osteonecrosis of the Jaws: A Literature Review

Journal of Oral Medicine and Pain 2022³â 47±Ç 1È£ p.1 ~ 9
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±è°æ¹Ì ( Kim Gyeong-Mi ) - Chosun University School of Dentistry Department of Oral and Maxillofacial Surgery
¹®¼º¿ë ( Moon Seong-Yong ) - Chosun University School of Dentistry Department of Oral and Maxillofacial Surgery
À¯Àç½Ä ( You Jae-Seek ) - Chosun University School of Dentistry Department of Oral and Maxillofacial Surgery
±è°æÀ± ( Kim Gyeong-Yun ) - Chosun University School of Dentistry Department of Oral and Maxillofacial Surgery
¿ÀÁö¼ö ( Oh Ji-Su ) - Chosun University School of Dentistry Department of Oral and Maxillofacial Surgery

Abstract


Medication-related osteonecrosis of the jaw (MRONJ) is a serious side effect of antiresorptive agents and bone-modifying agents. It is of the utmost importance to know the management of the MRONJ to improve the patient¡¯s quality of life. This study comprehensively reviews the current definitions of MRONJs, and antiresorptive medications, clinical manifestation and staging, risk factors, treatment strategies, and prevention methods of MRONJ. The disease is defined as an exposure of bone and osteonecrosis of the jaw in the oral cavity for at least 8 weeks in patients taking antiresorptive drugs or antiangiogenic agents and with no history of radiotherapy treatment of the jaws. Many articles have reported risk factors associated with MRONJ such as systemic diseases, antiresorptive medication, oral infection, and poor oral hygiene. Osteonecrosis and antiresorptive medications including bisphosphonate and denosumab have been strongly associated, but the pathology of MRONJ is only limited. Hence, an effective and appropriate management and treatment for MRONJ is still to be defined. The objectives of MRONJ treatment are to minimize osteonecrosis and relieve symptoms, and many treatments are suggested from conservative treatment to marginal resection, but this remains controversial. Appropriate treatment of MRONJ remained difficult, although many studies are being covered.

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Bisphosphonate; Denosumab; Jaw; Osteoporosis; Romosozumab

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