Denosumab, a human monoclonal antibody, is used for the prevention of malignant tumor-related bone events and the treatment of osteoporosis with high fracture risk. Since its approval in China in 2019, denosumab-related osteonecrosis of the jaw (DRONJ) has attracted increasing attention. DRONJ, similar to bisphosphonate-related osteonecrosis of the jaw, often occurs after tooth extraction and manifests as exposed bone necrosis, purulent discharge, facial swelling and pain, severely impacting patients' quality of life. However, the perioperative management strategies for DRONJ differ from those for bisphosphonate-related osteonecrosis of the jaw. This article summarizes the perioperative management strategies for high-risk DRONJ patients from aspects such as oral hygiene care, antibiotic use, drug discontinuation during the perioperative period, and surgical strategy selection, aiming to provide guidance for oral surgeons in managing tooth extraction in denosumab-treated patients.
Keyphrases
- end stage renal disease
- bone mineral density
- newly diagnosed
- ejection fraction
- chronic kidney disease
- peritoneal dialysis
- patients undergoing
- prognostic factors
- cardiac surgery
- postmenopausal women
- emergency department
- monoclonal antibody
- palliative care
- patient reported outcomes
- body composition
- chronic pain
- spinal cord injury
- working memory
- health insurance
- adverse drug