Antiresorptive treatment-associated ONJ

Area of Science:

• Oncology
• Oral Surgery
• Pharmacology

Background:

• Osteonecrosis of the jaw (ONJ) is a severe complication linked to antiresorptive agents (bisphosphonates, denosumab) used in cancer therapy.
• The incidence of ONJ ranges from 0-27.5%, influenced by treatment duration and dosage.
• While oral surgery and infections are known risk factors, ONJ can occur without apparent triggers.

Purpose of the Study:

• To review the risk factors, prevention strategies, and management of osteonecrosis of the jaw (ONJ).
• To highlight the impact of ONJ on patients' quality of life.
• To identify areas for future research in ONJ.

Main Methods:

• Review of available data on antiresorptive agent therapy and osteonecrosis of the jaw.
• Identification of established and potential risk factors for ONJ development.
• Analysis of current preventive and therapeutic approaches for ONJ.

Main Results:

• Antiresorptive agents, particularly with prolonged use or high dosage, increase ONJ risk.
• Oral surgical procedures and infections are significant risk factors, but idiopathic cases are emerging.
• ONJ can lead to irreversible jaw bone necrosis, impacting quality of life.

Conclusions:

• Meticulous dental screening and oral hygiene are fundamental for ONJ prevention.
• Current treatments are primarily conservative for symptom relief and necrosis management, with surgery as an option.
• Further research is needed on individual predisposition, enhanced prevention, and effective therapies for ONJ.