Decade-long review sheds light on osteonecrosis of the jaw

Osteonecrosis of the jaw
Osteonecrosis of the jaw is a serious dental condition

A new study has thrown new light onto the risk factors and causes surrounding osteonecrosis of the jaw, a condition with serious implications for treatments such as dental implants.

Among other key findings, the paper highlights a number of increased risk factors. Patients taking certain drugs for osteoporosis, anti-cancer drugs or glucocorticoids, those undergoing dental surgery, and people with poor oral hygiene, chronic inflammation, diabetes, or ill-fitting dentures, are more likely to develop osteonecrosis of the jaw.

The systematic review looks at literature published between January 2003 to April 2014 relating to the incidence, pathophysiology, diagnosis, and treatment of osteonecrosis of the jaw.

It goes on to highlight a number of prevention strategies that could help at-risk individuals, including elimination or stabilisation of oral disease prior to initiation of antiresorptive agents, as well as the maintenance of good oral hygiene.


Osteonecrosis of the jaw

Osteonecrosis of the jaw is a serious condition, characterised by mandibular or maxillary bone being exposed through gingival lesions that do not heal. It is often – though not always – accompanied by pain and inflammation, and may lead to secondary infection of the area. Osteonecrosis of the jaw can adversely affect the success rates of many dental procedures.

The review also discusses approaches for managing the condition, explaining that this is based ‘on the stage of the disease, size of the lesions, and the presence of contributing drug therapy and comorbidity’.

As well as explaining approaches for conservative – topical antibiotic oral rinses and systemic antibiotics – therapies, and localised surgical debridement for advanced, non-responsive cases, it highlights a number of other treatment options that are currently being researched.

This ‘experimental’ therapy includes bone marrow stem cell intralesional transplantation, low-level laser therapy, local platelet-derived growth factor application, hyperbaric oxygen, and tissue grafting. Early data also suggests that teriparatide can lead to enhanced osseous wound healing, the paper adds.

‘Patients need to maintain good oral hygiene especially if they are taking antiresorptive therapy in order to reduce their risk,’ added lead author Dr Aliya Khan.

The review appeared in the January 2015 issue of the Journal of Bone and Mineral Research.

The abstract and further information is available here.

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