Article
Analysis of different therapeutic protocols for osteonecrosis of the jaw associated with oral and intravenous bisphosphonates
Author/s | Bermúdez-Bejarano, Elena Beatriz
Serrera Figallo, María de los Ángeles Gutiérrez Pérez, José Luis Romero-Ruiz, Manuel María Castillo-de-Oyagüe, Raquel Gutiérrez Pérez, José Luis Machuca-Portillo, Guillermo Torres-Lagares, Daniel |
Department | Universidad de Sevilla. Departamento de Estomatología Instituto de Biomedicina de Sevilla (IBIS) |
Publication Date | 2017 |
Deposit Date | 2024-07-17 |
Published in |
|
Abstract | Introduction: Chemotherapy-associated osteonecrosis of the jaw caused by bisphosphonates is an exposure of
necrotic bone with more than eight weeks of evolution that is attributable to bisphosphonates and no prior radia ... Introduction: Chemotherapy-associated osteonecrosis of the jaw caused by bisphosphonates is an exposure of necrotic bone with more than eight weeks of evolution that is attributable to bisphosphonates and no prior radia tion therapy. Its etiopathogenesis remains unknown, although there are two hypotheses that may explain it: the drug’s mechanism of action, and the risk factors that can lead to osteonecrosis. There is a wide range of treatment options for managing chemotherapy-associated osteonecrosis of the jaw, from conservative treatments to surgical procedures of varying levels of invasiveness, which are sometimes supplemented with adjuvant therapies. Objectives: The objective of this article is to group the therapeutic options for osteonecrosis of the jaw (ONJ) into seven different protocols and to evaluate their effectiveness in relation to stage of ONJ. Material and Methods: A literature review was carried out in PubMed following the PRISMA criteria. A total of 47 were collected after compiling a series of variables that define ONJ, applied treatments, and the clinical results obtained. Results and Discussion: The 47 articles selected have a low to average estimated risk of bias and are of moderate to good quality. According to the data obtained, Protocol 3 (conservative treatment, clinical and radiological follow up, minimally invasive surgical treatment, and adjuvant therapies) is the most favorable approach for ONJ lesions caused by oral bisphosphonates. For lesions caused by intravenous bisphosphonates, Protocol 2 (conservative treatment, clinical and radiological follow-up, minimally invasive surgical treatment, and no adjuvant therapies) is the best approach. When comparing the different stages of ONJ, Protocol 1 (conservative treatment, clinical and radiological follow-up) promotes better healing of Stage 1 ONJ lesions caused by orally administered bisphos phonates, and Protocol 3 is recommended for Stage II. For ONJ lesions attributable to intravenous bisphosphonates, Protocol 7 (conservative treatment, clinical and radiological follow-up, and adjuvant therapies) provides the best results in Stage 0; in Stages I, II, and III, Protocol 1 gives better results. |
Citation | Bermúdez-Bejarano, E.B., Serrera Figallo, M.d.l.Á., Gutiérrez Pérez, J.L., Romero-Ruiz, M.M., Castillo-de-Oyagüe, R., Gutiérrez Pérez, J.L.,...,Torres-Lagares, D. (2017). Analysis of different therapeutic protocols for osteonecrosis of the jaw associated with oral and intravenous bisphosphonates. Medicina oral, patología oral y cirugía bucal, 22 (1), E43-E57. https://doi.org/10.4317/medoral.21477. |
Files | Size | Format | View | Description |
---|---|---|---|---|
Analysis of different therapeu ... | 1.204Mb | [PDF] | View/ | |
This item appears in the following collection(s)
This document is protected by intellectual and industrial property rights. Without prejudice to existing legal exemptions, its reproduction, distribution, public communication or transformation is prohibited without the authorization of the rights holder, unless otherwise indicated.