Title: Medication-Related osteonecrosis of the jaw; How much do we know?
Abstract:
Bisphosphonate (BF) is a class of drugs that prevents bone resorption and remodeling, and have been efficiently and safely used to treat osteoporosis, hypercalcemia of malignancy, bone metastasis of solid malignant rumors, Peget’s disease of the bone.
However the use of (BF) was found to cause side effects of which BRONJ as the most adverse effect.
Bisphosphonate-Related Osteonecrosis of the Jaw (BRONJ) can be described as an area of exposed necrotic bone in the mouth more than 8 weeks either affecting the maxilla or the mandible in a person taking any BF and had not had radiation therapy in the craniofacial region.
BRONJ rarely reported prior to 2001. In September 2004, Novartis: manufacturer of intravenous BF pamisronate (Aredia) and zoledronic acid (Zometa), notified healthcare professionals of additions of the labeling of these products which provides cautionary language related to the development of osteonecrosis of the jaw (ONJ). In 2005: the FDA issued warning for the entire drug class (including oral BF).
Treatment recommendations exist, but a standard therapy has not yet been established for BRONJ.
Ruggiero et al, in 2006 proposed guidelines for the diagnosis, staging and management of BRONJ. Later Ruggiero at al and the American Association of Oral and Maxillofacial Surgery (AAOMS) reported their position paper on BRONJ with an update of the previous classification (2014).
This lecture will cover:
-Bisphosphonates
-Their clinical applications
-drug chemistry and actions
-Side effects of BF
-BRONJ
-Staging of BRONJ
-Treatment of BRONJ
-Latest management and recommendations
