The effects of osteoclast modifiers on the oral
Date de l'article :
2013-02-15
Auteurs :
Matthew S. Epsteina, Joel B. Epsteinb, and Hillel D. Ephrosc,d
Affiliations :
aOral and Maxillofacial Surgery Resident, St. Joseph’s Regional Medical
Center, Paterson, New Jersey, bDivision of Otolaryngology and Head and
Neck Surgery, City of Hope, Duarte, California, Medical Staff, Cedars
Sinai Health System, Los Angeles, California, cSeton Hall University
School of Health and Medical Sciences, South Orange and dSt. Joseph’s
Regional Medical Center, Paterson, New Jersey, USA
Source :
Curr Opin Support Palliat Care 2012, 6:337–341
Abstract :
Purpose of review
Osteonecrosis of the jaw associated with therapeutic osteoclast modifiers is a rare but serious event. The
consequences of osteonecrosis can be devastating despite current treatment. With the increase in diversity
of agents and significant increase in the prevalence of osteoclast modifiers prescribed by oncologists
understanding diagnosis and management of osteoclast modifiers-related osteonecrosis of the jaws
(OMRONJ) is necessary. The risk of osteonecrosis when osteoclast modifiers are used for management of
osteoporosis is much less than osteoclast modifiers used in the oncology setting. A basic understanding of
the oral exam and current management will lead to more effective communication and more effective
prevention of devastating OMRONJ.
Recent findings
An indistinguishable rate of ONJ seen with new therapeutic agents is becoming apparent and relevant preventive therapy and counseling of the patient is indicated. Currently there is no comprehensive clinical guideline that unifies oncologists and oral health providers in the prevention and management of
OMRONJ.
Summary
Communication and proper planning with each patient’s provider is the most effective strategy to prevent OMRONJ. A team composed of an oncologist, oral and maxillofacial surgeon and dentist competent in managing this condition is necessary. An understanding of the cause and development of OMRONJ can
give the prescriber an improved perspective to communicate with oral health professional colleagues. Current guidelines emphasize the need for dental management prior to the use of osteoclast modifiers for the prevention and management of osteonecrosis of the jaw.
Commentaires :
Bonne revue sur les causes qui peuvent entraîner une ostéonécrose de la mâchoire chez les patients recevant des biphosphonates ou de l'Exgeva (denosumab) […]