Treatment perspectives for medication-related osteonecrosis of the jaw (MRONJ)

Oliver Ristow; Sven Otto; Matthias Troeltzsch; Bettina Hohlweg-Majert; Christoph Pautke

doi:10.1016/j.jcms.2014.11.014

Treatment perspectives for medication-related osteonecrosis of the jaw (MRONJ)

J Craniomaxillofac Surg. 2015 Mar;43(2):290-3. doi: 10.1016/j.jcms.2014.11.014. Epub 2014 Nov 22.

Authors

Oliver Ristow¹, Sven Otto², Matthias Troeltzsch², Bettina Hohlweg-Majert³, Christoph Pautke⁴

Affiliations

¹ University of Heidelberg, Department of Oral and Maxillofacial Surgery, Im Neuenheimer Feld 400, D-69120 Heidelberg, Germany; Medizin & Aesthetik, Clinic for Oral and Maxillofacial and Plastic Surgery, Lenbachplatz 2a, D-80333 Munich, Germany. Electronic address: oliver.ristow@med.uni-heidelberg.de.
² Ludwig-Maximilians Universität München, Department of Oral and Maxillofacial Surgery, Lindwurmstr. 2a, D-80336 Munich, Germany.
³ Medizin & Aesthetik, Clinic for Oral and Maxillofacial and Plastic Surgery, Lenbachplatz 2a, D-80333 Munich, Germany; Technische Universität München, Department of Oral and Maxillofacial Surgery, Ismaninger Str. 22, D-81675 Munich, Germany.
⁴ Medizin & Aesthetik, Clinic for Oral and Maxillofacial and Plastic Surgery, Lenbachplatz 2a, D-80333 Munich, Germany; Ludwig-Maximilians Universität München, Department of Oral and Maxillofacial Surgery, Lindwurmstr. 2a, D-80336 Munich, Germany.

PMID: 25541255
DOI: 10.1016/j.jcms.2014.11.014

Abstract

The medication-related osteonecrosis of the jaw (MRONJ) is believed to be a therapy-resistant entity. Although the application of the recommended conservative and surgical treatment regimens have returned variable success rates, the increased awareness and experience with MRONJ suggests that surgical therapy can halt the progression of the disease, thereby allowing a histology-based diagnosis of the osteonecrosis. Surgical treatment protocols can achieve success rates of over 90% and novel techniques such as the visualization of bone fluorescence can assist in the intra-operative delineation of the osteonecrosis and standardize the procedure.

Keywords: BRONJ; Bisphosphonate; Denosumab; Fluorescence-guided bone resection; Osteonecrosis of the jaw; Surgical treatment.

Publication types

Review

MeSH terms

Bisphosphonate-Associated Osteonecrosis of the Jaw / diagnosis
Bisphosphonate-Associated Osteonecrosis of the Jaw / surgery*
Debridement / methods
Disease Progression
Fluorescence
Humans
Intraoperative Care
Osteotomy / methods
Treatment Outcome