Skip to main content Skip to main navigation menu Skip to site footer
Review
Published: 04-04-2023

Relationship of the occurrence and main approaches to osteonecrosis of the jaw with the use of bisphosphonates: a concise systematic review

UNORTE - University Center of Northern São Paulo, Dentistry department, São José do Rio Preto, São Paulo, Brazil / UNIPOS - Post graduate and continuing education, Dentistry department, São José do Rio Preto, São Paulo, Brazil
UNORTE - University Center of Northern São Paulo, Dentistry department, São José do Rio Preto, São Paulo, Brazil / UNIPOS - Post graduate and continuing education, Dentistry department, São José do Rio Preto, São Paulo, Brazil
UNORTE - University Center of Northern São Paulo, Dentistry department, São José do Rio Preto, São Paulo, Brazil / UNIPOS - Post graduate and continuing education, Dentistry department, São José do Rio Preto, São Paulo, Brazil
UNORTE - University Center of Northern São Paulo, Dentistry department, São José do Rio Preto, São Paulo, Brazil / UNIPOS - Post graduate and continuing education, Dentistry department, São José do Rio Preto, São Paulo, Brazil
UNORTE - University Center of Northern São Paulo, Dentistry department, São José do Rio Preto, São Paulo, Brazil / UNIPOS - Post graduate and continuing education, Dentistry department, São José do Rio Preto, São Paulo, Brazil
Bisphosphonates Osteonecrosis Bone regeneration Oral and maxillofacial surgery

Abstract

Introduction: In the setting of bucomaxillo facial surgery, bone tissue is a specialized connective tissue made up of cells and a mineralized extracellular matrix. To reduce the excessive resorption observed in these pathologies, it has been studied more rigorously in pre-clinical and clinical studies to improve anti-resorptive drugs that allow for treating or preventing pathologies of bone metabolism, such as bisphosphonates (BP) and denosumab (DN) as well as some angiogenesis inhibitors, can induce osteonecrosis of the mandible (ONJ). Objective: Was to carry out a concise systematic review of the relation of occurrence and main approaches to osteonecrosis of the mandible and/or maxilla with the use of bisphosphonates.  Methods: The present study was followed by a systematic review model (PRISMA). The search strategy was performed in the PubMed, Cochrane Library, Web of Science and Scopus, and Google Scholar databases. The Cochrane Instrument was used to assess the risk of bias from the included studies. The present study was carried out from December 2022 to January of 2023. Results and Conclusion: A total of 108 articles were found. Initially, duplicate articles were excluded. After this process, the abstracts were evaluated and a new exclusion was performed based on the GRADE Instrument and Risk of Bias. A total of 55 articles were fully evaluated and 22 were included and discussed in this study. The American Association of Oral and Maxillofacial Surgeons proposed for the first time its nomenclature "Bisphosphonates Related Osteonecrosis of the Jaws". ONJ is the term used to describe bone cell death when the osteocyte becomes necrotic.  Osteonecrosis of the jaws can be considered a severe adverse effect of BP therapy. Osteonecrosis of the jaws induced by the use of antiresorptive drugs commonly occurs in the oral cavity, mainly because the bone tissue is covered and protected only by a thin layer of periosteum and epithelium. Bisphosphonates inhibit RANKL expression, as well as stimulate OPG production by bone marrow cells and osteoblasts, inhibiting the RANK-RANKL interaction. These synergistic actions lead to a decrease in the recruitment of osteoclasts and, consequently, to a reduction in bone resorption.

Metrics

Metrics Loading ...

References

  1. Ruggiero SL, Dodson TB, Aghaloo T, Carlson ER, Ward BB, Kademani D. American Association of Oral and Maxillofacial Surgeons' Position Paper on Medication-Related Osteonecrosis of the Jaws-2022 Update. J Oral Maxillofac Surg. 2022 May;80(5):920-943. doi: 10.1016/j.joms.2022.02.008.
  2. Anastasilakis AD, Pepe J, Napoli N, Palermo A, Magopoulos C, Khan AA, Zillikens MC, Body JJ. Osteonecrosis of the Jaw and Antiresorptive Agents in Benign and Malignant Diseases: A Critical Review Organized by the ECTS. J Clin Endocrinol Metab. 2022 Apr 19;107(5):1441-1460. doi: 10.1210/clinem/dgab888.
  3. Wang M, Wu YF, Girgis CM. Bisphosphonate Drug Holidays: Evidence From Clinical Trials and Real-World Studies. JBMR Plus. 2022 May 24;6(6):e10629. doi: 10.1002/jbm4.10629.
  4. Priyadarshini V, Ramachandra SS, Ganganna A. Awareness and Attitude Among Physicians' About Bisphosphonate-Related Osteonecrosis of the Jaw (BRONJ): A Cross-sectional study. Curr Drug Saf. 2022 May 14. doi: 10.2174/1574886317666220514160507.
  5. Vieira AE, Repeke CE, Ferreira Junior Sde B, Colavite PM, Biguetti CC, Oliveira RC, Assis GF, Taga R, Trombone AP, Garlet GP. Intramembranous bone healing process subsequent to tooth extraction in mice:m icrocomputedtomography, histomorphometric and molecular characterization. PLoS One. 2015 May 29;10(5):e0128021. doi: 10.1371/journal.pone.0128021. eCollection 2015.
  6. Vermeer JA, Renders GA, Everts V. Osteonecrosis of the Jaw-a Bone SiteSpecific Effect of Bisphosphonates. Curr Osteoporos Rep. 2016 Oct;14(5):219- 25. doi: 10.1007/s11914-016-0318-z.
  7. Ruggiero SL. et al. American Association of Oral and Maxillofacial Surgeons position paper on medication-related osteonecrosis of the jaw-2014 update. Journal of Oral and Maxillofacial Surgery, 2014, 72(10):1938-1956.
  8. Chaves RAC, Órfão AMA, Júnior WB, Queiroz TP, Faloni AP. Bifosfonatos e denosumabes: mecanismos de ação e algumas implicações para a implantodontia. Revista Brasileira Multidisciplinar-ReBraM, 2018, 21:2.
  9. Schiodt M, Otto S, Fedele S, Bedogni A, Nicolatou-Galitis O, Guggenberger R, Herlofson BB, Ristow O, Kofod T. Workshop of European Task Force on Medication Related Osteonecrosis of the Jaw.Current challenges. Oral Dis. 2019 Jul 20. doi: 10.1111/odi.13160.
  10. De Souza Faloni AP, Queiroz TP, Comelli Lia RC, Cerri PS, Margonar R, Rastelli AN, Marcantonio E. Accurate approach in the treatment of oral bisphosphonaterelated jaw osteonecrosis. J Craniofac Surg. 2011 Nov;22(6):2185-90. doi: 10.1097/SCS.0b013e318232410b.
  11. Agaçayak KS, Yuksel H, Atilgan S, Koparal M, Uçan MC, Ozgöz M, Yaman F, Atalay Y, Acikan I. Experimental investigation of relationship between trauma and bisphosphonaterelatedosteonecrosis. Niger J Clin Pract. 2014 Sep-Oct;17(5):559-64. doi: 10.4103/1119-3077.141417.
  12. Borumandi F, Aghaloo T, Cascarini L, Gaggl A, Fasanmade K. Antiresorptive Drugs and their Impact on Maxillofacial Bone among Cancer Patients. Anticancer Agents Med Chem. 2015;15(6):736-43.
  13. Savino S, Toscano A, Purgatorio R, Profilo E, Laghezza A, Tortorella P, Angelelli M, Cellamare S, Scala R, Tricarico D, Marobbio CMT, Perna F, Vitale P, Agamennone M, Dimiccoli V, Tolomeo A, Scilimati A. Novel bisphosphonates with antiresorptive effect in bone mineralization and osteoclastogenesis. Eur J Med Chem. 2018 Oct 5;158:184-200. doi: 10.1016/j.ejmech.2018.08.044. Epub 2018 Aug 18.
  14. Kuroshima S, Sasaki M, Sawase T. Medication-related osteonecrosis of the jaw: A literature review. J Oral Biosci. 2019 Jun;61(2):99-104. doi: 10.1016/j.job.2019.03.005. Epub 2019 May 15.
  15. Nixon JE. Avascular necrosis of bone: a review. JR Soc Med. 1983Aug; 76(8):681–692.
  16. Otto, Sven. Antiresorptive drug-related osteonecrosis of the jaw (ARONJ)-a guide to research. Eds. Kenneth E. Fleisher, and Risto Kontio. Thieme, 2016, AO Foundation, ISBN: 978-3-905363-10-4, Davos, Switzerland.
  17. Goss AN. Osteonecrosis of the jaw and denosumab. Aust Prescr. 2022 Dec;45(6):208-209. doi: 10.18773/austprescr.2022.066.
  18. S Otto, Medication related osteonecrosis of the jaws 2016. ISBN 978-3-662- 43732-2. DOI 0.1007/978-3-662-43733-9. Springer Heidelberg New York Dordrecht London.
  19. Ruggiero SL, Dodson TB, Fantasia J, et al. American Associatio of Oral and Maxillofacial Surgeons position paper on medication-related osteonecrosis of the jaw—2014 update. J Oral Maxillofac Surg. 2014 Oct; 72(10):1938–1956.
  20. Marx RE. Pamidronate (Aredia) and zoledronate (Zometa)induced avascular necrosis Treatment strategies and outcomes of BRONJ 579 of the jaws: a growing epidemic. J Oral Maxillofac Surg 2003;61:1115–7
  21. Bartl R, Frisch B, Tresckow E, Bartl C. (2007). Bisphosphonates in medical practice: actions-side effects-indications-strategies. Springer Science & Business Media.
  22. De Ponte Francesco Saverio, Bisphosphonates and Osteonecrosis of the Jaws: A Multidisciplinary Approach. 2011. Springer.

How to Cite

Cardoso, L. G. R. M., Sousa, F. O. de, Cicareli, A. J., Kassis, E. N., & Manzini, R. (2023). Relationship of the occurrence and main approaches to osteonecrosis of the jaw with the use of bisphosphonates: a concise systematic review. MedNEXT Journal of Medical and Health Sciences, 4(S2). https://doi.org/10.54448/mdnt23S201