Comprehensive Review of Prevention and Management Strategies for Medication-related Osteonecrosis of the Jaw (MRONJ).

IF 1.4 4区医学 Q3 DENTISTRY, ORAL SURGERY & MEDICINE

Oral health & preventive dentistry Pub Date : 2025-08-05 DOI:10.3290/j.ohpd.c_2169

Nasimeh Baghalipour, Omid Moztarzadeh, Walla Samar, Jiri Gencur, Vaclav Volf, Lukas Hauer

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引用次数: 0

Abstract

Purpose: To assess and classify the strategies employed in various dental specialities for the prevention and management of medication-related osteonecrosis of the jaw (MRONJ).

Materials and methods: A comprehensive literature review was conducted, acquiring studies sourced from Google Scholar and PubMed. The emphasis was on studies published in recent years, focusing on successful MRONJ prevention techniques across various dental specialties.

Results: Four types of prevention were identified. Primary prevention strategies include optimizing oral hygiene, managing dental caries, and extraction of hopeless teeth in patients before starting antiresorptive or antiangiogenic medications, to reduce MRONJ risk. Secondary prevention techniques involve tailored approaches during procedures employed during different dental specialties aimed at reducing complications in susceptible patients. Tertiary prevention focuses on managing established MRONJ, aiming to relieve symptoms and prevent further deterioration. Quaternary prevention seeks to limit overmedicalisation and reduce risks associated with medications that contribute to MRONJ development.

Conclusion: Primary prevention remains the prevention of choice in terms of minimising the possible incidence of MRONJ, while secondary and tertiary prevention strategies are vital for managing risks and improving outcomes in susceptible patients. Quaternary prevention requires more research focusing on reducing the incidence of underlying conditions such as osteoporosis and cancer, which are associated with MRONJ development.

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药物相关性颌骨骨坏死（MRONJ）的预防和治疗策略综述。

目的：评估和分类不同牙科专科用于预防和处理药物相关性颌骨骨坏死（MRONJ）的策略。材料和方法：我们进行了全面的文献综述，获取了谷歌Scholar和PubMed上的研究。重点是近年来发表的研究，重点是在各种牙科专业中成功的MRONJ预防技术。结果：确定了四种预防措施。一级预防策略包括优化口腔卫生，管理龋齿，在患者开始使用抗吸收或抗血管生成药物之前拔除无望的牙齿，以减少MRONJ风险。二级预防技术包括在不同牙科专业的手术中采用量身定制的方法，旨在减少易感患者的并发症。三级预防侧重于管理已建立的MRONJ，旨在缓解症状并防止进一步恶化。四级预防旨在限制过度用药，降低与导致MRONJ发展的药物相关的风险。结论：一级预防仍然是减少MRONJ发生率的首选预防措施，而二级和三级预防策略对于易感患者的风险管理和改善预后至关重要。四级预防需要更多的研究，重点是减少与MRONJ发展相关的潜在疾病，如骨质疏松症和癌症的发病率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Oral health & preventive dentistry DENTISTRY, ORAL SURGERY & MEDICINE-

CiteScore

3.00

自引率

0.00%

发文量

审稿时长

>12 weeks

期刊介绍： Clinicians, general practitioners, teachers, researchers, and public health administrators will find this journal an indispensable source of essential, timely information about scientific progress in the fields of oral health and the prevention of caries, periodontal diseases, oral mucosal diseases, and dental trauma. Central topics, including oral hygiene, oral epidemiology, oral health promotion, and public health issues, are covered in peer-reviewed articles such as clinical and basic science research reports; reviews; invited focus articles, commentaries, and guest editorials; and symposium, workshop, and conference proceedings.