Medication-Related Osteonecrosis of the Jaw (MRONJ): Current Practice, New Tools and Future Trends

Editors


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Collection Editor
Post-Graduate School of Oral Surgery, University of Messina, 66100 Chieti, Italy
Interests: dentistry; periodontal diseases; oral diseases; oral implant related diseases; osseo necrosis of the jaws

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Collection Editor
Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, 00161 Rome, Italy
Interests: oral pathology; oral medicine; oral cancer; oral surgery; laser
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Collection Editor
Department of Surgical, Oncological, and Oral Sciences, University of Palermo, 90127 Palermo, Italy
Interests: oral surgery; oral medicine; osteonecrosis of the jaw; oral squamous cell carcinoma
Special Issues, Collections and Topics in MDPI journals

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Collection Editor
Unit of Maxillofacial Surgery, Department of Neuroscience-DNS, University of Padua, 35122 Padua, Italy
Interests: maxillofacial surgery; head and neck oncology; reconstructive microsurgery; trauma; osteonecrosis of the jaws; osteoradionecrosis

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Collection Editor
Medical Oncology Unit, Azienda Ospedaliera di Alessandria, 15121 Alessandria, Italy
Interests: multiple myeloma; prevention; BRONJ; mronj; bisphosphonate; zoledronic acid; pamidronate; osteonecrosis of the jaws

Topical Collection Information

Dear Colleagues,

Medication-related osteonecrosis of the Jaw (MRONJ) is an adverse drug reaction described as the progressive destruction and death of bone that affects the mandible and maxilla of patients exposed to the treatment with medications known to increase the risk of disease, in the absence of a previous radiation treatment.

Osteonecrosis of the jaw has been described for the first time more than 15 years ago; since that time, thousands of paper have been published on the topic, showing the progress of research in this area. What we know is that MRONJ may lead to a reduced quality of life due to jaw bone infections, chronic pain, tooth loss, impaired function, and disfigurement. However, despite significant advancement in our comprehension of the disease, there remain several controversial issues.

Indeed, one of the most recurrent question is “Which is the correct treatment strategy for patients affected by MRONJ?”

Simultaneously, surgical techniques have advanced considerably and several new tools have been proposed, such as lasers or piezoelectric devices. Additionally, team-based multidisciplinary patient management has been applied in MRONJ prevention and treatment, improving patient outcomes beyond traditional operative strategies.

This Topical Collection is focused on, but not limited to, advances and innovations in MRONJ treatment highlighting novel surgical approaches or devices and outcomes of clinical management protocols.

We invite you to submit high-quality original research articles or reviews that provide new findings on MRONJ extending the current state of knowledge. All manuscripts will be peer-reviewed by experts in the field.

Prof. Dr. Giacomo Oteri
Prof. Dr. Umberto Romeo
Dr. Rodolfo Mauceri
Prof. Dr. Alberto Bedogni
Dr. Vittorio Fusco
Collection Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the collection website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Oral is an international peer-reviewed open access quarterly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1000 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

 

Keywords

  • osteonecrosis of the jaw
  • medication-related osteonecrosis of the jaw
  • antiresorptive agents
  • antiangiogenic agents
  • oral surgical procedures
  • oral health
  • oral prevention
  • public health dentistry
  • laser therapy
  • piezosurgery
  • autologous platelet concentrates

Published Papers (2 papers)

2022

Jump to: 2021

9 pages, 2576 KiB  
Review
The Role of the Laser Photobiomodulation (PBM) in the Management of Patients at Risk or Affected by MRONJ
by Alessandro Del Vecchio, Gianluca Tenore, Daniele Pergolini, Federica Rocchetti, Gaspare Palaia and Umberto Romeo
Oral 2022, 2(1), 7-15; https://doi.org/10.3390/oral2010002 - 17 Jan 2022
Cited by 2 | Viewed by 3388
Abstract
Medication-Related Osteo-Necrosis of the Jaws (MRONJ) is a severe painful complication of the long-lasting administration of bisphosphonates and anti-resorptive and anti-angiogenetic drugs in neoplastic and dysmetabolic patients, secondary to minor surgical oral interventions or chronic epithelial decubitus ulcers. Its pathogenesis is still largely [...] Read more.
Medication-Related Osteo-Necrosis of the Jaws (MRONJ) is a severe painful complication of the long-lasting administration of bisphosphonates and anti-resorptive and anti-angiogenetic drugs in neoplastic and dysmetabolic patients, secondary to minor surgical oral interventions or chronic epithelial decubitus ulcers. Its pathogenesis is still largely unknown even if the activity change of the osteoclasts plays a relevant role in bone remodeling. The management of these patients aims to prevent the onset of the pathology or to reduce the pain and remove the necrotic bone, promoting the healing of the pathological area. Photobiomodulation therapy (PBMT), the therapeutic application of low-energy laser or LED lights, was recently introduced in the management of this condition. Thanks to its therapeutic and biomodulating action on the irradiated tissues, PBM can be used alone or in combination with antibiotic and antibacterial therapies as a preventive, antalgic or palliative tool, and in support of surgery in a combined multi-protocol that leads to a positive and better resolution and healing of the pathologic process, with great improvement of the Quality of Life (QoL) of the patients. In this narrative review, a wide analysis of the various applications of PBM in MRONJ patients’ management is analyzed, emphasizing its role as supportive care for this condition. Full article
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2021

Jump to: 2022

6 pages, 2422 KiB  
Case Report
Oral Squamous Cell Carcinoma Mimicking Medication-Related Osteonecrosis of the Jaws (MRONJ): A Case Series
by Rodolfo Mauceri, Corrado Toro, Vera Panzarella, Martina Iurato Carbone, Vito Rodolico and Giuseppina Campisi
Oral 2021, 1(4), 326-331; https://doi.org/10.3390/oral1040032 - 3 Nov 2021
Cited by 3 | Viewed by 3580
Abstract
(1) Background: Medication-related osteonecrosis of the jaw (MRONJ) is a potential adverse drug reaction of antiresorptive and/or antiangiogenic treatment. MRONJ is mostly diagnosed by anamnestic data, clinical examination and radiological findings, with signs and symptoms often unspecific. On the other hand, oral squamous [...] Read more.
(1) Background: Medication-related osteonecrosis of the jaw (MRONJ) is a potential adverse drug reaction of antiresorptive and/or antiangiogenic treatment. MRONJ is mostly diagnosed by anamnestic data, clinical examination and radiological findings, with signs and symptoms often unspecific. On the other hand, oral squamous cell carcinoma (OSCC) is characteristic for its pleomorphic appearance (e.g., ulcer, mucous dehiscence, non-healing post-extractive socket). We report three cases where OSCC mimicked MRONJ lesions. (2) Patients: Three patients undergoing amino-bisphosphonate treatment for osteoporosis presented with areas of intraorally exposed jawbone and unspecific radiological signs compatible with MRONJ. Due to the clinical suspicious of malignant lesion, incisional biopsy for histological examination was also performed. (3) Results: Histological examination of the tissue specimen revealed the presence of OSCC. All patients underwent cancer treatment. (4) Conclusions: Several signs and symptoms of OSCC may simulate, in patients with a history of anti-resorptive, MRONJ; for these reasons, it is important to perform histologic analysis when clinicians are facing a suspicious malignant lesion. Full article
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Figure 1

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