Pathogenesis and multidisciplinary management of medication-related osteonecrosis of the jaw.
Lina HeXiangyu SunZhijie LiuYanfen QiuYumei NiuPublished in: International journal of oral science (2020)
Medication-related osteonecrosis of the jaw (MRONJ) is a serious side effect of bone-modifying agents and inhibits angiogenesis agents. Although the pathogenesis of MRONJ is not entirely clear, multiple factors may be involved in specific microenvironments. The TGF-β1 signalling pathway may have a key role in the development of MRONJ. According to the clinical stage, multiple variables should be considered when selecting the most appropriate treatment. Therefore, the prevention and management of treatment of MRONJ should be conducted in patient-centred multidisciplinary team collaborative networks with oncologists, dentists and dental specialists. This would comprise a closed responsibility treatment loop with all benefits directed to the patient. Thus, in the present review, we aimed to summarise the pathogenesis, risk factors, imaging features, clinical staging, therapeutic methods, prevention and treatment strategies associated with MRONJ, which may provide a reference that can inform preventive strategies and improve the quality of life for patients in the future.
Keyphrases
- risk factors
- end stage renal disease
- healthcare
- quality improvement
- case report
- newly diagnosed
- high resolution
- chronic kidney disease
- ejection fraction
- mass spectrometry
- peritoneal dialysis
- bone mineral density
- endothelial cells
- combination therapy
- replacement therapy
- pet ct
- photodynamic therapy
- epithelial mesenchymal transition
- prognostic factors
- vascular endothelial growth factor