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Bone
Article . 2020 . Peer-reviewed
License: CC BY
Data sources: Crossref
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Bone
Article
License: CC BY
Data sources: UnpayWall
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Lirias
Article . 2020
Data sources: Lirias
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Adjuvant therapies for MRONJ: A systematic review

Authors: Govaerts, Dries; Piccart, Frederik; Ockerman, Anna; Coropciuc, Ruxandra; Politis, Constantinus; Jacobs, Reinhilde;

Adjuvant therapies for MRONJ: A systematic review

Abstract

Medication-related osteonecrosis of the jaw (MRONJ) is a severe adverse reaction caused by the use of antiresorptive antiangiogenic medication. Treating MRONJ is difficult and besides standard treatments, which are conservative medical and surgical approaches, there are some adjuvant therapies that might further stimulate healing. The aim of this systematic review is to compare outcome and effectiveness of currently available adjuvant therapies for MRONJ.This systematic review was conducted following the PRISMA guidelines. Articles focusing on mucosal healing in patients treated with an adjuvant therapy for MRONJ were selected and analysed. Inclusion was not limited to randomized controlled trials to present a complete review of the current literature.A search was performed in Pubmed, Embase, Web of Science and Cochrane Central Register of Controlled Trials. Thirty articles out of 3297 were included. Laser ablation had a success of 60-95% for complete healing. The controlled trials of leukocyte- and platelet-rich-fibrine (LPRF) showed 60-100% success for the same outcome. Fluorescence guided surgery had a complete healing percentage of 85-90%.The results suggest that laser ablation, LPRF and fluorescence guided surgery might have a potential in improving the healing process. Interpreting the results should however be done with great care and a critical point of view, as most articles had a medium to high risk of bias. More randomized controlled trials are necessary to define the most beneficial therapy protocols.It seems that adjuvant surgical therapies for treating MRONJ are beneficial for mucosal healing, but there is only low scientific evidence.

Country
Belgium
Keywords

AVASCULAR NECROSIS, MEDICATION-RELATED OSTEONECROSIS, BONE MORPHOGENETIC PROTEIN-2, 09 Engineering, Endocrinology & Metabolism, Medication-related osteonecrosis of the jaw, Humans, 11 Medical and Health Sciences, HYPERBARIC-OXYGEN, Science & Technology, Bone Density Conservation Agents, Osteonecrosis, 3202 Clinical sciences, Bisphosphonates, AMERICAN ASSOCIATION, 06 Biological Sciences, PLATELET-RICH FIBRIN, LPRF, SURGICAL-TREATMENT, laser ablation, Bisphosphonate-Associated Osteonecrosis of the Jaw, Therapy, BISPHOSPHONATE-RELATED OSTEONECROSIS, Denosumab, OZONE THERAPY, Life Sciences & Biomedicine, SURGEONS POSITION PAPER

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    selected citations
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    This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
    52
    popularity
    This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
    Top 1%
    influence
    This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
    Top 10%
    impulse
    This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
    Top 10%
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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
52
Top 1%
Top 10%
Top 10%
Green
hybrid