TREATMENT STRATEGIES AND OUTCOMES IN MEDICATION-RELATED OSTEONECROSIS OF THE JAWS

Abstract

Osteonecrosis of the jaw secondary to bone-modifying agents (BMA) and antiangiogenic agents (AAA) without known antiresorptive properties is now a well-documented complication associated with a wide range of medications prescribed for the treatment of a plethora of conditions ranging from management of osteoporosis to preventing adverse skeletal-related events in oncologic treatment. Medication-related Osteonecrosis of the Jaws (MRONJ) which was generally unheard of prior to 2003, has become a ubiquitous condition reported and managed by many dental clinics worldwide. Despite increasing scientific interest in the condition, our understanding regarding the condition remains sorely inadequate. The epidemiology regarding the condition has also been reported inconsistently in literature. Singapore has one of the longest life expectancies internationally and it is no wonder that osteoporosis and management of metastatic bone disease proves a significant healthcare issue amongst our aging population. At our centre, we have observed a rising trend in the number of referrals for (A) initiation of dental clearance prior to initiation of MRONJassociated agents and (B) management of possible MRONJ.