Multidisciplinary expert position statement on the prevention and management of osteonecrosis of the jaws related to bone resorption inhibitors
Introduction: medication-related osteonecrosis of the jaw (ONMRJ) is a serious complication associated with the use of antiresorptive drugs, such as bisphosphonates and denosumab, indicated for osteoporosis and oncological diseases with bone involvement. Its clinical management continues to be contr...
| Autores: | , , , , , , , |
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| Tipo de recurso: | artículo |
| Estado: | Versión publicada |
| Fecha de publicación: | 2025 |
| País: | España |
| Institución: | Universidad de Sevilla (US) |
| Repositorio: | idUS. Depósito de Investigación de la Universidad de Sevilla |
| OAI Identifier: | oai:dnet:idus________::3eeeb12e5cbdcbbffe1b498a0d514618 |
| Acceso en línea: | https://hdl.handle.net/11441/184715 https://doi.org/10.20960/revosteoporosmetabminer.00107 |
| Access Level: | acceso abierto |
| Palabra clave: | Antiresorptive drugs Antiangiogenic drugs Bisphosphonates Denosumab Bone exposure in the jaws Medication-related osteonecrosis of the jaw Maxillary osteonecrosis Fármacos antirresortivos Antiangiogénicos Bisfosfonatos Exposición ósea en los maxilares Osteonecrosis de los maxilares relacionada con Medicación Osteonecrosis maxilar |
| Sumario: | Introduction: medication-related osteonecrosis of the jaw (ONMRJ) is a serious complication associated with the use of antiresorptive drugs, such as bisphosphonates and denosumab, indicated for osteoporosis and oncological diseases with bone involvement. Its clinical management continues to be controversial due to variability in diagnostic, prevention, and treatment strategies. Objective: to develop a multidisciplinary position paper that summarizes the main international and national recommendations on the prevention and management of ONJ, as well as to propose clinical practice strategies that promote therapeutic adherence and minimize the risk of complications. Materials and methods: a literature review and telematic meetings were held with specialists in oral and Maxillofacial Surgery, Dentistry, Rheumatology, Endocrinology, Hematology, and Medical Oncology to formulate recommendations based on scientific evidence and expert opinion. Results: the main drugs involved in ONMRM, risk profiles, predisposing factors, diagnostic criteria, and clinical staging are identified. Clinical action algorithms are provided for prevention and treatment in patients with osteoporosis or cancer (bone metastases and/or myeloma), as well as guidelines for invasive dental procedures. The need for interdisciplinary coordination and the implementation of strategies that promote patient education and therapeutic adherence are also addressed. Conclusion: ONMRM presents great variability in its diagnosis, prevention, and therapeutic approach. This document provides clinicians with recommendations for managing these patients from a multidisciplinary approach. In order to ensure proper prevention, the importance of prior dental evaluation, risk factor control, and patient education is emphasized. Treatment should be tailored to each case, prioritizing conservative options and promoting adherence to treatment. |
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