İlaçlara Bağlı Gelişen Çene Kemiği Osteonekrozlarının Yönetiminde Güncel Değişimler
Yıl 2024,
Cilt: 13 Sayı: 1, 202 - 219, 26.01.2024
Onur Şahin
,
Mustafa Hacılar
Öz
Antirezorptif ilaçlar osteoporoz, Paget hastalığı gibi kemik metabolizmasını ilgilendiren hastalıkların tedavisinde ve metastatik kemik tümörlerinin önlenmesinde hastaların hayat kalitesini arttırmak ve ağrı şikayetlerini azaltmak amacı ile sıklıkla tercih edilen ilaçlardır. Antirezorptif ilaç kullanımına bağlı olarak gelişen osteonekroz (İÇKON) olguları 2000’li yıllardan itibaren artış göstermeye başlamıştır. Bu hastalığın patofizyolojisinin net olmaması kesin bir tedavi protokolünün olmamasına sebep olmuştur. Amerikan Oral ve Maksillofasiyal Cerrahi Derneği (AAOMS) 2007, 2009 ve 2014 yıllarında ilaçlara bağlı İÇKON ile ilişkili görüş bildirgeleri yayınlamıştır. Bu derlemenin amacı İÇKON olgularının etiyolojisini, klinik ve radyolojik bulgularını, risk faktörlerini ve farklı tedavi seçeneklerini 2022 yılında yayınlanan son güncellemeye göre değerlendirmektir.
Kaynakça
- Referans1. Marx RE. Pamidronate (Aredia) and zoledronate (Zometa)
induced avascular necrosis of the jaws: a growing epidemic. J
Oral Maxillofac Surg 2003;61:1115-7.
- Referans2. Stresing V, Daubiné F, Benzaid I, Mönkkönen H, Clezardin
P. Bisphosphonates in cancer therapy. Cancer Lett. 2007;257:
16–35
- Referans3. Malan J, Ettinger K, Naumann E et al. The relationship of
denosumab pharmacology and osteonecrosis of the jaws. Oral
Surg Oral Med Oral Pathol Oral Radiol 2012;114:671–76.
- Referans4. Serra E, Paolantonio M, Spoto G, Mastrangelo F, Tete S,
Dolci M. Bevacizumab- related osteneocrosis of the jaw. Int J
Immunopathol Pharmacol. 2009;22:1121-23.
- Referans5. Ruggiero SL, Dodson TB, Fantasia J, Goodday R, Aghaloo
T, Mehrotra B, O’Ryan F. American Association of Oral and
Maxillofacial Surgeons. American Association of Oral and
Maxillofacial Surgeons position paper on medication-related
osteonecrosis of the jaw--2014 update. J Oral Maxillofac Surg
2014;72:1938-56.
- Referans6. Rogers MJ, Watts DJ, Russell RG. Overview of Bisphosphonates.
Cancer 1997;80:1652-60.
- Referans7. Ruggiero SL, Dodson TB, Aghaloo T, Carlson ER, Ward BB,
Kademani D. American Association of Oral and Maxillofacial
Surgeons’ Position Paper on Medication-Related Osteonecrosis
of the Jaws-2022 Update. J Oral Maxillofac Surg 2022; 80: 920-
943.
- Referans8. Şahin O, Odabaşı O, Aliyev T, Tatar B. Risk factors of
medication-related osteonecrosis of the jaw: a retrospective study
in a Turkish subpopulation. J Korean Assoc Oral Maxillofac Surg
2019;45:108-15.
- Referans9. Yarom N, Fedele S, Lazarovici TS, Elad S. Is Exposure
of the Jawbone Mandatory for Establishing the Diagnosis of
Bisphosphonate-Related Osteonecrosis of the Jaw? J. Oral
Maxillofac. Surg 2010;68:705.
- Referans10. Şahin O, Odabaşi O, Ekmekcioğlu C. Ultrasonic Piezoelectric
Bone Surgery Combined With Leukocyte and Platelet-Rich
Fibrin and Pedicled Buccal Fat Pad Flap in Denosumab-Related
Osteonecrosis of the Jaw. J Craniofac Surg 2019; 30:e434-6.
- Referans11. Palla B, Anderson J, Miloro M, Moles S, Callahan.
Romosozumab-Associated Medication-Related Osteonecrosis
of the Jaw. Oral and Max. Surg. Cases 2023; doi:10.1016/j.
omsc.2023.100318.
- Referans12. Ruggiero SL, Dodson TB, Assael LA, Landesberg R, Marx
RE, Mehrotra B. American Association of Oral and Maxillofacial
Surgeons. American Association of Oral and Maxillofacial
Surgeons position paper on bisphosphonate- related
osteonecrosis of the jaw - 2009 update. J Oral Maxillofac Surg
2009;67:2-12.
- Referans13. Schiodt M, Otto S, Fedele S, Bedogni A, Nicolatou-Galitis O,
Guggenberger R, Herlofson BB, Ristow O, Kofod T. Workshop of
European task force on medication-related osteonecrosis of the
jaw-Current challenges. Oral Dis 2019;25:1815-21.
- Referans14. Yarom N, Shapiro CL, Peterson DE, Van Poznak CH, Bohlke
K, Ruggiero SL et al. Medication-Related Osteonecrosis of the
Jaw: MASCC/ISOO/ASCO Clinical Practice Guideline. J Clin
Oncol 2019;37:2270-90.
- Referans15. Khan AA, Morrison A, Kendler DL, Rizzoli R, Hanley DA,
Felsenberg D et al. International Task Force on Osteonecrosis
of the Jaw. Case-Based Review of Osteonecrosis of the Jaw
(ONJ) and Application of the International Recommendations for
Management From the International Task Force on ONJ. J Clin
Densitom 2017;20:8-24.
- Referans16. Japanese Allied Committee on Osteonecrosis of the Jaw;
Yoneda T, Hagino H, Sugimoto T, Ohta H, Takahashi S et al.
Antiresorptive agent-related osteonecrosis of the jaw: Position
Paper 2017 of the Japanese Allied Committee on Osteonecrosis
of the Jaw. J Bone Miner Metab 2017;35:6-19.
- Referans17. Şahin O, Odabaşı O, Demiralp KÖ, Kurşun-Çakmak EŞ, Aliyev
T. Comparison of findings of radiographic and fractal dimension
analyses on panoramic radiographs of patients with early-stage
and advanced-stage medication-related osteonecrosis of the jaw.
Oral Surg Oral Med Oral Pathol Oral Radiol 2019;1 28:78-86.
- Referans18. Otto S, Pautke C, Van den Wyngaert T, Niepel D, Schiødt
M. Medication-related osteonecrosis of the jaw: Prevention,
diagnosis and management in patients with cancer and bone
metastases. Cancer Treat. Rev 2018;69,177-87.
- Referans19. Şahin O, Akan E, Tatar B, Ekmekcioğlu C, Ünal N, Odabaşı
O. Combined approach to treatment of advanced stages of
medication-related osteonecrosis of the jaw patients. Braz J
Otorhinolaryngol 2022;88:613-20.
- Referans20. Fleisher KE, Janal MN, Albstein N, Young J, Bikhazi V,
Schwalb S, Wolff M, Glickman RS: Comorbid conditions are a risk
for osteonecrosis of the jaw unrelated to antiresorptive therapy.
Oral Surg Oral Med Oral Pathol Oral Radiol 2019;127:140.
- Referans21. Ramaglia L, Guida A, Iorio-Siciliano V, Cuozzo A, Blasi A,
Sculean A. Stage-specific therapeutic strategies of medicationrelated
osteonecrosis of the jaws: a systematic review and
metaanalysis of the drug suspension protocol. Clin Oral Investig
2018;22:597–615.
- Referans22. Campisi G, Mauceri R, Bertoldo F, Bettini G, Biasotto M,
Colella G, Consolo U et al. Medication-Related Osteonecrosis
of Jaws (MRONJ) Prevention and Diagnosis: Italian Consensus
Update 2020. Int J Environ Res Public Health 2020;17:5998.
- Referans23. Black DM, Reid IR, Boonen S, Bucci-Rechtweg C, Cauley
JA, Cosman F et al. The effect of 3 versus 6 years of zoledronic
acid treatment of osteoporosis: a randomized extension to the
HORIZON-Pivotal Fracture Trial (PFT). J Bone Miner Res 2012;
27:243.
- Referans24. El-Rabbany M, Lam DK, Shah PS, Azarpazhooh A. Surgical
management of medication-related osteonecrosis of the jaw
is associated with improved disease resolution: a retrospective
cohort study. J Oral Maxillofac Surg 2019;77:1816–22.
- Referans25. Aljohani S, Troeltzsch M, Hafner S, Kaeppler G, Mast G, Otto
S. Surgical treatment of medication-related osteonecrosis of the
upper jaw: case series. Oral Dis. 2019;25:497–507.
- Referans26. Aghaloo T, Hazboun R, Tetradis S: Pathophysiology of
Osteonecrosis of the Jaws. Oral Maxillofac Surg Clin North Am
2015;27:489.
- Referans27. Sahin O. Medication-related osteonecrosis of the jaw: A
survey of knowledge, practices and opinions of dentists. Ann Med
Res 2020;27:2421-7.
- Referans28. Şahin O, Tatar B, Ekmekcioğlu C, Aliyev T, Odabaşı O.
Prevention of medication related osteonecrosis of the jaw after
dentoalveolar surgery: An institution’s experience. J Clin Exp
Dent 2020;12:e771-6.
- Referans29. Kawahara, M., Kuroshima, S. & Sawase, T. Clinical
considerations for medication-related osteonecrosis of the jaw:
a comprehensive literature review. Int J Implant Dent 2021;7:47.
- Referans30. Rossi, M., Gambino, A., Cabras, M., Alessio, M. & Fusco, V.
Persistence, compliance, discontinuation rates and switch rates
in denosumab and bisphosphonate treatment of bone metastases
in cancer patients: reasons of switch, osteonecrosis of the jaw
(ONJ) and other critical points. Support Care Cancer 2021;29:
4185-6.
- Referans31. Ogata K, Katagiri W, Osugi M, Kawai T, Sugimura Y, Hibi
H, Nakamura S, Ueda M. Evaluation of the therapeutic effects
of conditioned media from mesenchymal stem cells in a rat
bisphosphonate-related osteonecrosis of the jaw-like model.
Bone 2015;74:95-105.
- Referans32. Gurel C, Inetas G, Hortu I, Tunc E, Kuscu GC, Dindaroglu FC,
Sahin O, Buhur A, Oktem G. Cancer and Cancer Stem Cells: New
Molecular Perspectives. Crit Rev Oncog 2019; 24: 99-104.
- Referans33. Nicolatou-Galitis O, Schiødt M, Mendes RA, Ripamonti C,
Hope S, Drudge-Coates L,et al. Medication-related osteonecrosis
of the jaw: definition and best practice for prevention, diagnosis,
and treatment. Oral Surg Oral Med Oral Pathol Oral Radiol 2019;
127:117-35.
- Referans34. Ng TL, Tu MM, Ibrahim MFK, Basulaiman B, McGee SF,
Srikanthan A, et al. Long-term impact of bone-modifying agents
for the treatment of bone metastases: a systematic review.
Support Care Cancer 2021;29:925.
- Referans35. AlRowis R, Aldawood A, AlOtaibi M, Alnasser E, AlSaif I,
Aljaber A, et al. Medication-Related Osteonecrosis of the Jaw
(MRONJ): A Review of Pathophysiology, Risk Factors, Preventive
Measures and Treatment Strategies. Saudi Dent J 2022;34:202-
10
- Referans36. Kawahara M, Kuroshima S, Sawase T. Clinical considerations
for medication-related osteonecrosis of the jaw: a comprehensive
literature review. Int J Implant Dent 2021;14:47.
- Referans37. Kuroshima S, Al-Omari FA, Sasaki M, Sawase T. Medicationrelated
osteonecrosis of the jaw: A literature review and update.
Genesis 2022;60:e23500.
- Referans38. Neal TW, Schlieve T. Medication-Related Osteonecrosis of
the Jaws in the Pediatric Population. J Oral Maxillofac Surg 2022;
80:1686-90.
- Referans39. Ottesen C, Schiodt M, Gotfredsen K. Efficacy of a high-dose
antiresorptive drug holiday to reduce the risk of medicationrelated
osteonecrosis of the jaw (MRONJ): A systematic review.
Heliyon. 2020;6:e03795.
- Referans40. Gaudin E, Seidel L, Bacevic M, Rompen E, Lambert
F: Occurrence and risk indicators of medication-related
osteonecrosis of the jaw after dental extraction: a systematic
review and meta-analysis. J Clin Periodontol 2015;42:922.
- Referans41. Bonacina R, Mariani U, Villa F, Villa A. Preventive strategies
and clinical implications for bisphosphonate-related osteonecrosis
of the jaw: a review of 282 patients. J Can Dent Assoc 2011;77:
b147.
- Referans42. Granate-Marques A, Polis-Yanes C, Seminario-Amez M,
Jané-Salas E, López-López J. Medication-related osteonecrosis
of the jaw associated with implant and regenerative treatments:
Systematic review. Med Oral Patol Oral Cir Bucal 2019; 24:
e195-e203.
- Referans43. Stavropoulos A, Bertl K, Pietschmann P, Pandis N, Schiødt
M, Klinge B. The effect of antiresorptive drugs on implant
therapy: Systematic review and meta-analysis. Clin Oral Implants
Res2018; 29 Suppl 18:54-92.
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osteonecrosis of the jaw in older adult patients with osteoporosis?
A national cohort propensity score-matched study. Clin Oral
Implants Res 2021;32:437-47.
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LM. Medication-related osteonecrosis of the jaw. Implant
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C. Medication-related osteonecrosis of the jaw (MRONJ) stage
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(L-PRF) for the treatment of medication-related osteonecrosis of
the jaw (MRONJ) with long term follow-up. Biomed J Sci Tech
Res 2018;2:1–3.
- Referans49. El-Rabbany M, Lam DK, Shah PS, Azarpazhooh A. Surgical
management of medication-related osteonecrosis of the jaw
is associated with improved disease resolution: a retrospective
cohort study. J Oral Maxillofac Surg 2019;77:1816–22.
- Referans50. Bodem JP, Schaal C, Kargus S. Surgical management of
bisphosphonate-related osteonecrosis of the jaw stages II and
III. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2016;121:
367–72.
Current Changes in the Management of Medication Related Osteonecrosis of the Jaw
Yıl 2024,
Cilt: 13 Sayı: 1, 202 - 219, 26.01.2024
Onur Şahin
,
Mustafa Hacılar
Öz
Antiresorptive drugs are frequently preferred in the treatment of diseases related to bone metabolism such as osteoporosis and Paget's disease, and in the prevention of metastatic bone tumors, to increase the quality of life of patients and to reduce pain complaints. Osteonecrosis cases due to the use of antiresorptive drugs (MRONJ) have started to increase since the 2000s. The unclear pathophysiology of this disease has led to the lack of a definitive treatment protocol. The American Associaton of Oral and Maxillofacial Surgeons (AAOMS) published position paper regarding medication related osteonecrosis of the jaw in 2007, 2009 and 2014. The aim of this review is to evaluate the etiology, clinical and radiological findings, risk factors and different treatment options of MRONJ cases according to the last update published in 2022.
Kaynakça
- Referans1. Marx RE. Pamidronate (Aredia) and zoledronate (Zometa)
induced avascular necrosis of the jaws: a growing epidemic. J
Oral Maxillofac Surg 2003;61:1115-7.
- Referans2. Stresing V, Daubiné F, Benzaid I, Mönkkönen H, Clezardin
P. Bisphosphonates in cancer therapy. Cancer Lett. 2007;257:
16–35
- Referans3. Malan J, Ettinger K, Naumann E et al. The relationship of
denosumab pharmacology and osteonecrosis of the jaws. Oral
Surg Oral Med Oral Pathol Oral Radiol 2012;114:671–76.
- Referans4. Serra E, Paolantonio M, Spoto G, Mastrangelo F, Tete S,
Dolci M. Bevacizumab- related osteneocrosis of the jaw. Int J
Immunopathol Pharmacol. 2009;22:1121-23.
- Referans5. Ruggiero SL, Dodson TB, Fantasia J, Goodday R, Aghaloo
T, Mehrotra B, O’Ryan F. American Association of Oral and
Maxillofacial Surgeons. American Association of Oral and
Maxillofacial Surgeons position paper on medication-related
osteonecrosis of the jaw--2014 update. J Oral Maxillofac Surg
2014;72:1938-56.
- Referans6. Rogers MJ, Watts DJ, Russell RG. Overview of Bisphosphonates.
Cancer 1997;80:1652-60.
- Referans7. Ruggiero SL, Dodson TB, Aghaloo T, Carlson ER, Ward BB,
Kademani D. American Association of Oral and Maxillofacial
Surgeons’ Position Paper on Medication-Related Osteonecrosis
of the Jaws-2022 Update. J Oral Maxillofac Surg 2022; 80: 920-
943.
- Referans8. Şahin O, Odabaşı O, Aliyev T, Tatar B. Risk factors of
medication-related osteonecrosis of the jaw: a retrospective study
in a Turkish subpopulation. J Korean Assoc Oral Maxillofac Surg
2019;45:108-15.
- Referans9. Yarom N, Fedele S, Lazarovici TS, Elad S. Is Exposure
of the Jawbone Mandatory for Establishing the Diagnosis of
Bisphosphonate-Related Osteonecrosis of the Jaw? J. Oral
Maxillofac. Surg 2010;68:705.
- Referans10. Şahin O, Odabaşi O, Ekmekcioğlu C. Ultrasonic Piezoelectric
Bone Surgery Combined With Leukocyte and Platelet-Rich
Fibrin and Pedicled Buccal Fat Pad Flap in Denosumab-Related
Osteonecrosis of the Jaw. J Craniofac Surg 2019; 30:e434-6.
- Referans11. Palla B, Anderson J, Miloro M, Moles S, Callahan.
Romosozumab-Associated Medication-Related Osteonecrosis
of the Jaw. Oral and Max. Surg. Cases 2023; doi:10.1016/j.
omsc.2023.100318.
- Referans12. Ruggiero SL, Dodson TB, Assael LA, Landesberg R, Marx
RE, Mehrotra B. American Association of Oral and Maxillofacial
Surgeons. American Association of Oral and Maxillofacial
Surgeons position paper on bisphosphonate- related
osteonecrosis of the jaw - 2009 update. J Oral Maxillofac Surg
2009;67:2-12.
- Referans13. Schiodt M, Otto S, Fedele S, Bedogni A, Nicolatou-Galitis O,
Guggenberger R, Herlofson BB, Ristow O, Kofod T. Workshop of
European task force on medication-related osteonecrosis of the
jaw-Current challenges. Oral Dis 2019;25:1815-21.
- Referans14. Yarom N, Shapiro CL, Peterson DE, Van Poznak CH, Bohlke
K, Ruggiero SL et al. Medication-Related Osteonecrosis of the
Jaw: MASCC/ISOO/ASCO Clinical Practice Guideline. J Clin
Oncol 2019;37:2270-90.
- Referans15. Khan AA, Morrison A, Kendler DL, Rizzoli R, Hanley DA,
Felsenberg D et al. International Task Force on Osteonecrosis
of the Jaw. Case-Based Review of Osteonecrosis of the Jaw
(ONJ) and Application of the International Recommendations for
Management From the International Task Force on ONJ. J Clin
Densitom 2017;20:8-24.
- Referans16. Japanese Allied Committee on Osteonecrosis of the Jaw;
Yoneda T, Hagino H, Sugimoto T, Ohta H, Takahashi S et al.
Antiresorptive agent-related osteonecrosis of the jaw: Position
Paper 2017 of the Japanese Allied Committee on Osteonecrosis
of the Jaw. J Bone Miner Metab 2017;35:6-19.
- Referans17. Şahin O, Odabaşı O, Demiralp KÖ, Kurşun-Çakmak EŞ, Aliyev
T. Comparison of findings of radiographic and fractal dimension
analyses on panoramic radiographs of patients with early-stage
and advanced-stage medication-related osteonecrosis of the jaw.
Oral Surg Oral Med Oral Pathol Oral Radiol 2019;1 28:78-86.
- Referans18. Otto S, Pautke C, Van den Wyngaert T, Niepel D, Schiødt
M. Medication-related osteonecrosis of the jaw: Prevention,
diagnosis and management in patients with cancer and bone
metastases. Cancer Treat. Rev 2018;69,177-87.
- Referans19. Şahin O, Akan E, Tatar B, Ekmekcioğlu C, Ünal N, Odabaşı
O. Combined approach to treatment of advanced stages of
medication-related osteonecrosis of the jaw patients. Braz J
Otorhinolaryngol 2022;88:613-20.
- Referans20. Fleisher KE, Janal MN, Albstein N, Young J, Bikhazi V,
Schwalb S, Wolff M, Glickman RS: Comorbid conditions are a risk
for osteonecrosis of the jaw unrelated to antiresorptive therapy.
Oral Surg Oral Med Oral Pathol Oral Radiol 2019;127:140.
- Referans21. Ramaglia L, Guida A, Iorio-Siciliano V, Cuozzo A, Blasi A,
Sculean A. Stage-specific therapeutic strategies of medicationrelated
osteonecrosis of the jaws: a systematic review and
metaanalysis of the drug suspension protocol. Clin Oral Investig
2018;22:597–615.
- Referans22. Campisi G, Mauceri R, Bertoldo F, Bettini G, Biasotto M,
Colella G, Consolo U et al. Medication-Related Osteonecrosis
of Jaws (MRONJ) Prevention and Diagnosis: Italian Consensus
Update 2020. Int J Environ Res Public Health 2020;17:5998.
- Referans23. Black DM, Reid IR, Boonen S, Bucci-Rechtweg C, Cauley
JA, Cosman F et al. The effect of 3 versus 6 years of zoledronic
acid treatment of osteoporosis: a randomized extension to the
HORIZON-Pivotal Fracture Trial (PFT). J Bone Miner Res 2012;
27:243.
- Referans24. El-Rabbany M, Lam DK, Shah PS, Azarpazhooh A. Surgical
management of medication-related osteonecrosis of the jaw
is associated with improved disease resolution: a retrospective
cohort study. J Oral Maxillofac Surg 2019;77:1816–22.
- Referans25. Aljohani S, Troeltzsch M, Hafner S, Kaeppler G, Mast G, Otto
S. Surgical treatment of medication-related osteonecrosis of the
upper jaw: case series. Oral Dis. 2019;25:497–507.
- Referans26. Aghaloo T, Hazboun R, Tetradis S: Pathophysiology of
Osteonecrosis of the Jaws. Oral Maxillofac Surg Clin North Am
2015;27:489.
- Referans27. Sahin O. Medication-related osteonecrosis of the jaw: A
survey of knowledge, practices and opinions of dentists. Ann Med
Res 2020;27:2421-7.
- Referans28. Şahin O, Tatar B, Ekmekcioğlu C, Aliyev T, Odabaşı O.
Prevention of medication related osteonecrosis of the jaw after
dentoalveolar surgery: An institution’s experience. J Clin Exp
Dent 2020;12:e771-6.
- Referans29. Kawahara, M., Kuroshima, S. & Sawase, T. Clinical
considerations for medication-related osteonecrosis of the jaw:
a comprehensive literature review. Int J Implant Dent 2021;7:47.
- Referans30. Rossi, M., Gambino, A., Cabras, M., Alessio, M. & Fusco, V.
Persistence, compliance, discontinuation rates and switch rates
in denosumab and bisphosphonate treatment of bone metastases
in cancer patients: reasons of switch, osteonecrosis of the jaw
(ONJ) and other critical points. Support Care Cancer 2021;29:
4185-6.
- Referans31. Ogata K, Katagiri W, Osugi M, Kawai T, Sugimura Y, Hibi
H, Nakamura S, Ueda M. Evaluation of the therapeutic effects
of conditioned media from mesenchymal stem cells in a rat
bisphosphonate-related osteonecrosis of the jaw-like model.
Bone 2015;74:95-105.
- Referans32. Gurel C, Inetas G, Hortu I, Tunc E, Kuscu GC, Dindaroglu FC,
Sahin O, Buhur A, Oktem G. Cancer and Cancer Stem Cells: New
Molecular Perspectives. Crit Rev Oncog 2019; 24: 99-104.
- Referans33. Nicolatou-Galitis O, Schiødt M, Mendes RA, Ripamonti C,
Hope S, Drudge-Coates L,et al. Medication-related osteonecrosis
of the jaw: definition and best practice for prevention, diagnosis,
and treatment. Oral Surg Oral Med Oral Pathol Oral Radiol 2019;
127:117-35.
- Referans34. Ng TL, Tu MM, Ibrahim MFK, Basulaiman B, McGee SF,
Srikanthan A, et al. Long-term impact of bone-modifying agents
for the treatment of bone metastases: a systematic review.
Support Care Cancer 2021;29:925.
- Referans35. AlRowis R, Aldawood A, AlOtaibi M, Alnasser E, AlSaif I,
Aljaber A, et al. Medication-Related Osteonecrosis of the Jaw
(MRONJ): A Review of Pathophysiology, Risk Factors, Preventive
Measures and Treatment Strategies. Saudi Dent J 2022;34:202-
10
- Referans36. Kawahara M, Kuroshima S, Sawase T. Clinical considerations
for medication-related osteonecrosis of the jaw: a comprehensive
literature review. Int J Implant Dent 2021;14:47.
- Referans37. Kuroshima S, Al-Omari FA, Sasaki M, Sawase T. Medicationrelated
osteonecrosis of the jaw: A literature review and update.
Genesis 2022;60:e23500.
- Referans38. Neal TW, Schlieve T. Medication-Related Osteonecrosis of
the Jaws in the Pediatric Population. J Oral Maxillofac Surg 2022;
80:1686-90.
- Referans39. Ottesen C, Schiodt M, Gotfredsen K. Efficacy of a high-dose
antiresorptive drug holiday to reduce the risk of medicationrelated
osteonecrosis of the jaw (MRONJ): A systematic review.
Heliyon. 2020;6:e03795.
- Referans40. Gaudin E, Seidel L, Bacevic M, Rompen E, Lambert
F: Occurrence and risk indicators of medication-related
osteonecrosis of the jaw after dental extraction: a systematic
review and meta-analysis. J Clin Periodontol 2015;42:922.
- Referans41. Bonacina R, Mariani U, Villa F, Villa A. Preventive strategies
and clinical implications for bisphosphonate-related osteonecrosis
of the jaw: a review of 282 patients. J Can Dent Assoc 2011;77:
b147.
- Referans42. Granate-Marques A, Polis-Yanes C, Seminario-Amez M,
Jané-Salas E, López-López J. Medication-related osteonecrosis
of the jaw associated with implant and regenerative treatments:
Systematic review. Med Oral Patol Oral Cir Bucal 2019; 24:
e195-e203.
- Referans43. Stavropoulos A, Bertl K, Pietschmann P, Pandis N, Schiødt
M, Klinge B. The effect of antiresorptive drugs on implant
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