Management of patients with Medication Related Osteonecrosis of the Jaw - biphosphonates Flashcards
what is MRONJ?
Medication-related osteonecrosis of the jaw
It is defined as exposed bone, or bone that can be probed through an intraoral or extraoral fistula, in the maxillofacial region
What are symptoms of MRONJ?
Delayed healing following extraction
Pain
Soft tissue infection
Swelling
Numbness
Paraesthesia
Exposed bone
what are are anti-resorptive drugs and how do they work?
Bisphosphonates
Drugs that reduce bone resorption by hindering the formation and function of osteoclasts
what are some conditions that may be treated with biphosphonates?
Osteoporosis
Paget’s disease
Osteogenesis imperfecta
Breast Cancer
Prostate Cancer
Bony Metastatic Cancer
some common biphosphonates
Alendronic acid
Trade name- Binosto, Fosamax, Fosavance
Risedronate sodium
Trade name- Actonel, Actonel Combi
Zoledronic acid
Trade name- Aclasta, Zometa
Ibandronic acid
Trade name- Bondronat, Bonviva, Lasibon, Quodixor
Pamidronate disodium
Trade name- Aredia
Sodium clodronate
Trade name- Bonefos, Clasteon, Loron
What Are Anti-angiogenic Drugs and How Do They Work?
target the way in which new blood vessels are formed and used in cancer treatment to restrict tumour vascularisation
Some have been known to cause osteonecrosis of the jaw
They can be used in combination with bisphosphonates in cancer treatment
There is a possibility that this can lead to a greater risk of MRONJ
guidance for treatment with patients on biphosphonates
Maintaining good oral hygiene
Having a healthy diet
Stopping smoking
Limiting alcohol
Regular dental checks
Report any symptoms such as exposed bone, non healing areas as soon as possible
