Medication-related Osteonecrosis of the Jaw (MRONJ)

Question 1

List examples of bisphosphonates.

Answer 1

alendronic acid
risedronate sodium
zoledronic acid
ibandronic acid
pamidronate disodium
sodium clodronate

Question 2

Example of RANKL inhibitor.

Answer 2

denosumab

Question 3

List examples of anti-angiogenic drugs.

Answer 3

bevacizumab
sunitinib
aflibercept

Question 4

What is considered a low-risk of developing MRONJ?

Answer 4

• no previous MRONJ
• not taking any anti-resorptive or anti-angiogenic drugs for cancer management
• currently taking a bisphosphonate drug or have taken in the past for less than 5 years
• currently taking denosumab or have taken in the last 9 months
• not concurrently treated with a systemic glucocorticoid

Question 5

What is considered a higher risk of developing MRONJ?

Answer 5

• previous MRONJ
• taking anti-resorptive or anti-angiogenic drugs for cancer management
• currently taking a bisphosphonate drug or have taken in the past for more than 5 years
• currently taking a bisphosphonate drug or have taken in the past for less than 5 years AND is concurrently treated with a systemic glucocorticoid

Question 6

What is MRONJ?

Answer 6

• rare side effect of bisphosphonate medication
• exposed bone in the maxillofacial region that has persisted for more than 8 weeks in patients with a history of treatment with anti-resorptive or anti-angiogenic drugs
• spontaneous or after dental treatment
• pain, loose teeth, tingling, numbness, altered sensation