What causes MRONJ?

MRONJ is an adverse reaction which can occur as a result of medicines used to treat cancer and osteoporosis. Some medications which induce these effects are bisphosphonates, denosumab and antiangiogenic agents.

How do you treat MRONJ?

MRONJ treatment considerations

1. Daily irrigation and antimicrobial rinse.
2. Antibiotics to control infection.
3. Surgical treatment to remove the necrotic bone may be advisable in more advanced cases.
4. In some patients a removable appliance to cover and protect the exposed bone is necessary.

How can we prevent MRONJ?

Primary prevention for MRONJ mainly means elimination/reduction of the oral and dental risk factors [5,11,15,27,28,29]; it is targeted at restoring and/or maintaining good oral health and reducing the risk of onset of pathological conditions or any other negative event.

How is MRONJ diagnosed?

A diagnosis of MRONJ should be considered when patients present with all three of the following criteria: (1) previous or current treatment with a BMA or angiogenesis inhibitor; (2) exposed bone or bone that can be probed through an intraoral or extraoral fistula in the maxillofacial region that has persisted for …

What medications can cause MRONJ?

Drugs with the highest risk of causing MRONJ were the bisphosphonates, particularly pamidronate (approximately 500 times greater risk compared to no exposure) and zoledronate (approximately 170 times greater risk). The RANKL inhibitor denosumab showed a 14% greater risk.

What drugs interact with bisphosphonates?

Drug Interactions Magnesium-containing drugs like Milk of Magnesia (magnesium hydroxide) or Maalox (magnesium with aluminum) Diuretics or “water pills” such as Lasix (furosemide) or Edecrin (ethacrynic acid) Antbiotics like Amphosin and Fungizone (amphotericin B), amikacin, or gentamicin.

What medication causes osteonecrosis?

Bisphosphonates — such as alendronate (Fosamax, Binosto), risedronate (Actonel, Atelvia), ibandronate (Boniva) and zoledronic acid (Reclast, Zometa) — and denosumab (Prolia, Xgeva) have been linked to osteonecrosis of the jaw and atypical femoral fractures.

How common is Mronj?

The reported incidence of MRONJ varies, but it is generally considered to be between 1% and 10% of patients taking IV bisphosphonates for the management of bone metastatic disease and between 0.001% and 0.01% in patients taking oral bisphosphonates for the management of osteoporosis.

How common is MRONJ?