Related Experiment Video
Updated: Dec 6, 2025
10:42
A Postoperative Evaluation Guideline for Computer-Assisted Reconstruction of the Mandible
Published on: January 28, 2020
6.8K
Adjuvant therapies for MRONJ: A systematic review
Dries Govaerts1, Frederik Piccart1, Anna Ockerman2
1OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, Catholic University Leuven, Belgium; Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium.
Bone
|October 6, 2020
Summary
Adjuvant therapies like laser ablation and leukocyte- and platelet-rich fibrin (LPRF) show promise for healing medication-related osteonecrosis of the jaw (MRONJ). However, more research is needed due to the current low evidence base.
Area of Science:
- Oral surgery
- Oncology
- Pharmacology
Background:
- Medication-related osteonecrosis of the jaw (MRONJ) is a severe complication of antiresorptive and antiangiogenic medications.
- Current treatments for MRONJ include conservative medical and surgical approaches, with limited options for stimulating healing.
- Adjuvant therapies are being explored to improve outcomes in MRONJ patients.
Purpose of the Study:
- To systematically review and compare the effectiveness of adjuvant therapies for MRONJ.
- To evaluate the outcomes of laser ablation, leukocyte- and platelet-rich fibrin (LPRF), and fluorescence-guided surgery in MRONJ treatment.
Main Methods:
- A systematic review following PRISMA guidelines was conducted.
- Literature search performed across major databases (PubMed, Embase, Web of Science, Cochrane).
- Thirty articles were included from 3297 initial records, focusing on mucosal healing in MRONJ patients treated with adjuvant therapies.
Main Results:
- Laser ablation demonstrated a 60-95% success rate for complete mucosal healing.
- Leukocyte- and platelet-rich fibrin (LPRF) showed a 60-100% success rate in controlled trials.
- Fluorescence-guided surgery achieved an 85-90% complete healing rate.
Conclusions:
- Laser ablation, LPRF, and fluorescence-guided surgery show potential as adjuvant therapies for MRONJ.
- Most studies reviewed had a medium to high risk of bias, necessitating cautious interpretation.
- Further randomized controlled trials are essential to establish optimal therapeutic protocols and confirm efficacy.
Keywords:
BisphosphonatesDenosumabLPRFMedication-related osteonecrosis of the jawOsteonecrosisTherapylaser ablationMore Related Videos
Related Concept Videos
01:24Drugs for Peptic Ulcer Disease: Sucralfate as Mucosal Protective Agents
1.1K
In the intricate landscape of the gastric lumen, excessive acid secretion disrupts the natural defense mechanisms, weakening the mucus-bicarbonate barrier. This vulnerability allows pepsin to infiltrate epithelial cells, digesting mucosal proteins and triggering erosion, leading to ulcer formation.
In this scenario, mucosal protective agents like sucralfate play an essential role. Sucralfate, a complex of sulfated sucrose and aluminum hydroxide, demonstrates its usefulness in acidic conditions,...
In this scenario, mucosal protective agents like sucralfate play an essential role. Sucralfate, a complex of sulfated sucrose and aluminum hydroxide, demonstrates its usefulness in acidic conditions,...
1.1K
01:28Chemotherapy-Induced Nausea and Vomiting: Neurokinin-1 Receptor Antagonists
412
Neurokinin 1 (NK1) receptors are distributed across the GI tract, vagal afferents, and key CNS regions including the central vomiting center and chemoreceptor trigger zone (CTZ) Chemotherapy agents stimulate enterochromaffin cells in the gastrointestinal (GI) tract to release large amounts of substance P (SP). SP is a neuropeptide released by specific sensory nerves in response to many different stressors, including those in the GI mucosa affected by chemotherapy. SP binds and activates...
412
01:40Bone Remodeling
39.8K
Bone remodeling is a continuous and balanced process of bone resorption by osteoclasts and bone formation by osteoblasts. In adults, it helps maintain bone mass and calcium homeostasis. While mechanical stress can stimulate turnover as part of the normal maintenance and reparative process, several hormones also regulate bone remodeling.
39.8K
01:26Peptic Ulcer Disease IV: Management
291
Medical treatment strategies for peptic ulcers encompass various methods. The primary goal of treatment is to diminish gastric acidity and strengthen mucosal defense mechanisms.
The therapeutic approach involves ensuring adequate rest, implementing drug therapy, promoting smoking cessation, making dietary modifications, and emphasizing long-term follow-up care.
Pharmacological management
The prevailing therapy for peptic ulcers involves a combination of managing the patient's current...
The therapeutic approach involves ensuring adequate rest, implementing drug therapy, promoting smoking cessation, making dietary modifications, and emphasizing long-term follow-up care.
Pharmacological management
The prevailing therapy for peptic ulcers involves a combination of managing the patient's current...
291
01:30Urinary Tract Calculi III: Medical Management
122
The diagnosis of renal calculi involves several imaging techniques, including non-contrast CT scans and ultrasound. These methods help visualize kidney stones, assess their size and location, and detect possible obstructions. Additionally, Measuring urine pH is useful for diagnosing specific stone types, such as struvite (alkaline pH) and uric acid stones (acidic pH). Cystine stones are primarily linked to cystinuria, a genetic condition. A urinalysis helps detect blood in the urine (hematuria)...
122
01:31Osteoclasts in Bone Remodeling
3.6K
Osteoclasts are cells responsible for bone resorption and remodeling. They originate from hematopoietic progenitor cells present in the bone marrow. Numerous progenitor cells fuse to form multinucleated cells, each with 10-20 nuclei. A single osteoclast has a diameter of 150 to 200 µM. These cells have ruffled borders that break down the underlying bone tissue and release minerals such as calcium into the blood in bone resorption. Osteoclasts cling to bones with their ruffled edges during...
3.6K