MRONJ Flashcards
How to avoid MRONJ
Dentally fit at least 2 weeks before tx
Avoid XLas
Atraumatic + suturing
Explain warning signs: delayed healing, unexpected pain, tingling, numbness/altered sensation or swelling in XLa area
Review healing in 8wks
What is MRONJ
Exposed bone or bone that can be probed through an I/O or E/O fistula
What causes MRONJ
Side effect of antiresorptive/anti-angiogenic drugs
Criteria to qualify as MRONJ
Exposed bone or bone that can be probed through an I/O or E/O fistula
Persisted for 8wks
Hx of tx with antiresorptive/anti-angiogenic drugs
No hx of radiation to jaw
How do bisphosphonates work?
Inhibit osteoclast function - bone resorbing
Indications for bisphosphonates
Prevent metastasis in cancer
Pagets
Osteoporosis
Osteogenesis Imperfecta
Fibrous dysplasia
How does Denosumab work?
Inhibits osteoclast function
RANKL inhibitor
How do anti-angiogenic drugs work?
Restrict tumour vascularisation
What growth factors are associated with anti-angiogenic drugs?
VEGF + RTK
Risk factors for MRONJ
XLa’s
Mucosal trauma from ill fitting dentures
Name examples of bisphosphonate drugs
Alendronic acid (osteoporosis)
Zoledronic acid (osteoporosis/pagets/tx of cancer)
Indication for Denosumab
Osteporosis/tx of cancer
High risk for MRONJ category
If being tx for cancer
If >5yrs on bisphosphonate
Denosumab/bisphosphonate + systemic glucocorticoid = high risk
