Osteonecrosis Essay

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INTRODUCTION: Malignancy such as multiple myeloma and metastases to the bone, a common occurrence in advance-stage disease, may necessitate the use of bone–modifying agents such as anti-resorptive medications, including pamidronate and zolendronate (intravenous bisphosphonates), denosumab (humanised monoclonal antibody) and anti-angiogenics such as sunitinib (tyrosine kinase inhibitor) and bavacizumab (humanized monoclonal antibody). Medication-related osteonecrosis of the jaw is a well-known complication of bone modifying agents used in the prevention of skeletal-related events such as bone fracture, spinal cord compression, radiotherapy or surgery in patients with metastatic disease and patients with osteoporosis or osteopenia. The risk of developing MRONJ in patients treated for metastatic disease is higher compared to patients of osteoporosis. Steroids, tobacco, immunosuppressive therapy and comorbidities like diabetes mellitus have been associated with an increased risk for MRONJ.…show more content…
Also discussed are the actions of the bisphosphonates, pathogenesis, predisposing risk factors for the development of MRONJ and diagnostic criteria.
METHODS: Review of literature of various journal articles considering: pathophysiology, risk factors, incidence and novel diagnostic and treatment modalities.
CONCLUSION: Clinical management of MRONJ remains controversial, with no established treatment guidelines. Different therapeutic approaches like chlorhexidine rinse, antibiotic therapy, pentoxyfylline and tocopherol, hyperbaric oxygen (HBO), low level laser therapy, laser surgery, surgery with or without fluorescence light or plasma rich protein (PRP) and stem cells have been utilized in the management of MRONJ with variable
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