Osteonecrosis of the jaw – Prevention and treatment strategies for oral health professionals

• Published in: Oral oncology Vol. 49; no. 9; pp. 878 - 886
• Main Authors: Hinchy, Nicole V, Jayaprakash, Vijayvel, Rossitto, Rachael A, Anders, Patrick L, Korff, Kathryn C, Canallatos, Paul, Sullivan, Maureen A
• Format: Journal Article
• Language: English
• Published: Kidlington Elsevier 01-09-2013
• Subjects: Biological and medical sciences; Dental Health Services - manpower; Diseases of the osteoarticular system; Facial bones, jaws, teeth, parodontium: diseases, semeiology; Hematology, Oncology and Palliative Medicine; Humans; Jaw Diseases - drug therapy; Jaw Diseases - prevention & control; Medical sciences; Multiple tumors. Solid tumors. Tumors in childhood (general aspects); Non tumoral diseases; Osteonecrosis - drug therapy; Osteonecrosis - prevention & control; Otolaryngology; Otorhinolaryngology. Stomatology; Risk Factors; Tumors; Vascular bone diseases; Osteoporosis; Dental clearance; Antiangiogenics; Antiresorptives; Aging population; ONJ; Osteonecrosis; Bisphosphonates; osteonecrosis of the jaws; Cancer survivorship; Jaw; Antiosteoporotic; Diseases of the osteoarticular system; Antiresorptive agent; ENT; Clearance; Prevention; Cancerology; Antiosteoclastic agent; Antiangiogenic agent; Stomatology; Dental disease; Malignant tumor; Oral cavity; Treatment; Bucco-dental health; Tooth; Cancer
• ISSN: 1368-8375; 1879-0593
• DOI: 10.1016/j.oraloncology.2013.06.008

Summary Patients diagnosed with multiple myeloma and metastatic breast, prostate and renal cancers have a better opportunity for longer survival due to a myriad of chemotherapies regimens that attempt to manage disease progression while decreasing treatment-related side effects. Osteonecrosis of the jaws (ONJ) is a known side effect of bisphosphonates and other anti-neoplastic drugs. This complication can lead to oncologic treatment interruptions as well as diminished quality of life. Most recommendations for treatment of ONJ are based on position papers and case reports, while evidence-based treatment paradigms are lacking. With cancer survivorship on the rise, long-term chemotherapeutic side effects are becoming more prevalent and attention to untoward oral complications cannot be understated. In this review, the accepted recommendations for dental clearance prior to head and neck chemo-radiation therapy are put forth as a means of possibly preventing and treating drug induced ONJ.