Management of bisphosphonate-related osteonecrosis of the jaw: a literature review.
Osteonecrosis of the jaw (ONJ) is a serious side effect of bisphosphonate use in patients with osteoporosis, Paget's disease, hypercalcemia of malignancy, metastatic bone disease and multiple myeloma, although recently this complication has also been reported in patients under non-bisphosphonate medication, such as denosumab and bevacizumab. The occurrence of ONJ is higher in oncology patients treated with high-dose iv bisphosphonates than in osteoporosis patients treated with oral bisphosphonates. Although multiple hypotheses have been proposed, the exact pathogenic mechanism of ONJ still remains unclear. As treatment protocols based on randomized controlled trials (RCTs) do not exist, we critically reviewed the existing data concerning the management of bisphosphonate-related osteonecrosis of the jaw, including the most recent data for the use of teriparatide and hyperbaric oxygen.
Postgraduate Course on Metabolic Bone Disease, Faculty of Medicine, University of Athens, Athens, Greece.
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Spanou
Postgraduate Course on Metabolic Bone Disease, Faculty of Medicine, University of Athens, Athens, Greece.
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Lyritis
Postgraduate Course on Metabolic Bone Disease, Faculty of Medicine, University of Athens, Athens, Greece.|2nd Orthopaedic Department, Konstantopoulion Hospital, University of Athens, Athens, Greece.
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Chronopoulos
Laboratory for Research of the Musculoskeletal System 'Th. Garofalidis', Medical School, KAT Hospital, University of Athens, Athens, Greece.
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Tournis
D059266:Bisphosphonate-Associated Osteonecrosis of the Jaw / Q000628:therapy*; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D000072700:Conservative Treatment / Q000379:methods; D006801:Humans; D006931:Hyperbaric Oxygenation; D053844:Lasers, Solid-State / Q000627:therapeutic use*; D019379:Teriparatide / Q000627:therapeutic use*
D050071:Bone Density Conservation Agents; D019379:Teriparatide
BRONJ treatment/management; bisphosphonate-related osteonecrosis of the jaw (BRONJ); hyperbaric oxygen; surgical therapy; teriparatide treatment