Effective treatment of osteonecrosis: A Synthesis of Findings from 42 Studies

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Original Abstract of the Article

Major research findings

Medication-related osteonecrosis of the jaw (MRONJ) is a serious adverse drug reaction that occurs as a progressive bone destruction in the maxillofacial region. MRONJ is usually initiated after oral surgery procedures, however periodontal disease and other chronic inflammations are also risk factors. 33 There is no clear treatment protocol for management of MRONJ, for this reason autologous platelet concentrates (APC) have been introduced to enhance the healing process. 38 compared surgical treatment and conservative treatment for MRONJ. It suggested surgical treatment might lead to slightly better outcomes, particularly for advanced disease stages, but there is a lack of standardized treatment protocols and outcome measures, and the overall quality of evidence is poor. 35 reviewed adjuvant therapies for MRONJ and concluded that there are some adjuvant therapies that might further stimulate healing.

Treatment summary

33 introduced autologous platelet concentrates (APC) to enhance the healing process of MRONJ. 38 compared surgical treatment and conservative treatment for MRONJ. 35 reviewed adjuvant therapies for MRONJ.

Benefits and risks

Benefit summary

Surgical treatment might lead to slightly better outcomes than conservative treatment for MRONJ. 38 APC may enhance the healing process. 33 Some adjuvant therapies might further stimulate healing of MRONJ. 35

Risk summary

The treatment for MRONJ has risks, including risks of surgery, infection, and drug side effects.

Comparison between studies

Commonalities between studies

The studies agree that there is no clear treatment protocol for the management of MRONJ.

Differences between studies

Different studies focused on different treatments, patient groups, and outcome measures.

Consistency and contradictions in results

While there is not enough research to come to a definitive conclusion on treatment methods, the studies have shown that there are some promising treatments for MRONJ, such as APC and some adjuvant therapies. Further research is needed to determine the effectiveness of these treatments.

Precautions for applying results to real life

MRONJ is a serious side effect that can happen to patients taking certain medications. To prevent MRONJ, maintaining good oral hygiene is important. 4 If you experience symptoms of MRONJ, it is important to contact a dentist and receive appropriate treatment.

Limitations of current research

The research on MRONJ is limited in quantity, quality, and uniformity.

Directions for future research

Future research should focus on understanding the pathogenesis of MRONJ, developing effective treatments, establishing standardized treatment protocols, and conducting long-term outcome studies.

Conclusion

MRONJ is a challenging condition to treat. There is no established standard of care, but some treatments, including surgical treatment, APC, and adjuvant therapies, show promise for improving outcomes. Maintaining good oral hygiene is crucial for preventing MRONJ. If you have symptoms of MRONJ, please contact your dentist for an appropriate treatment plan.

Treatment list

Treatments for MRONJ include surgical treatment, conservative treatment, and adjuvant therapy.

Keywords
Benefit Keywords
Osteonecrosis treatment
1
Early intervention
Joint preservation
2
Bisphosphonate therapy
3
Osteonecrosis of the jaw treatment
4
Femoral head preservation
7
Reduced THA incidence
8
Osteoporosis treatment
9
Reduced ONJ risk
10
Osseous reconstruction for BRONJ
11
BRONJ treatments
12
ONJ treatment
13
BRONJ prevention
BRONJ treatment
14
Treat osteonecrosis of the jaw
15
BRONJ treatment
Improved BRONJ outcomes
16
Osteoporosis treatment
18
Cell therapy for osteonecrosis
19
MRONJ resolution
21
Osteoporosis treatment
22
Osteonecrosis treatment
23
Improved Harris hip score
Reduced treatment failure
25
Improved BRONJ treatment
Shorter wound closure time
26
Osteonecrosis treatment
27
Micro-osseous-vascular reconstruction
ONJ treatment
28
Reduced osteonecrosis
29
Joint replacement treatment
Osteonecrosis treatment
31
MRONJ treatment
32
MRONJ treatment
33
Treatment options
34
MRONJ treatment
35
MRONJ treatment
36
Combined surgery
Conservative surgery
MRONJ treatment
37
Osteonecrosis of the jaw treatment
38
MRONJ treatment
39
ONFH treatment efficacy
40
Improved bone and mucosa healing
41
Risk Keywords
Osteonecrosis
2
Osteonecrosis
3
Bisphosphonate associated ONJ
4
Bisphosphonate osteonecrosis
5
Osteonecrosis of the jaw
6
Alendronate risk unclear
7
Insufficient evidence
Jaw osteonecrosis risk
9
Non-union for BRONJ
11
Osteonecrosis of the jaw
15
Heterogeneity of studies
Insufficient evidence
16
ONJ risk
17
BRONJ risk
18
AFF risk
ONJ risk
22
Bone destruction
Reduced quality of life
24
None mentioned
25
BRONJ
34
Lack of standardized treatment protocols
38
Osteonecrosis recurrence
41
Cell death
MRONJ
42
Literature analysis of 42 papers
Positive Content
33
Neutral Content
3
Negative Content
6
Article Type
7
7
33
26
42
1.

The use of alendronate to prevent early collapse of the femoral head in patients with nontraumatic osteonecrosis. A randomized clinical study.

Author: LaiKuo-An, ShenWun-Jer, YangChyun-Yu, ShaoChung-Jung, HsuJui-Ting, LinRuey-Mo

Osteonecrosis treatment

The study aimed to test the effect of alendronate in preventing early collapse of the femoral head in patients with nontraumatic osteonecrosis, as a potential alternative to surgical treatments.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

2.

Chemotherapy-associated osteonecrosis in cancer patients with solid tumours: a systematic review.

Author: ShimKatharine, MacKenzieMary J, WinquistEric

Early intervention
Joint preservation
Osteonecrosis

This review summarizes recent reports of osteonecrosis associated with chemotherapy in cancer patients.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

3.

[Bisphosphonate-associated osteonecrosis of the jaw in rheumatology: a systematic review].

Author: CapsoniF

Bisphosphonate therapy
Osteonecrosis

Osteonecrosis of the jaw (ONJ) is a potential side effect of bisphosphonate therapy for osteoporosis and Paget's disease, although the incidence is still rare.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : Italian

4.

Bisphosphonate associated osteonecrosis of the jaw.

Author: KhanAliya A, SándorGeorge K B, DoreEdward, MorrisonArchibald D, AlsahliMazen, AminFaizan, PetersEdmund, HanleyDavid A, ChaudrySultan R, LentleBrian, DempsterDavid W, GlorieuxFrancis H, NevilleAlan J, TalwarReena M, ClokieCameron M, MardiniMajd Al, PaulTerri, KhoslaSundeep, JosseRobert G, SutherlandSusan, LamDavid K, CarmichaelRobert P, BlanasNick, KendlerDavid, PetakSteven, Ste-MarieLouis Georges, BrownJacques, EvansA Wayne, RiosLorena, CompstonJuliet E,

Osteonecrosis of the jaw treatment
Bisphosphonate associated ONJ

This systematic review investigated the incidence, risk factors, diagnosis, prevention, and treatment of bisphosphonate-associated osteonecrosis of the jaw (ONJ).

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

5.

A systematic review of bisphosphonate osteonecrosis (BON) in cancer.

Author: MiglioratiCesar Augusto, WooSook-Bin, HewsonIan, BaraschAndrei, EltingLinda S, SpijkervetFred K L, BrennanMichael T,

Bisphosphonate osteonecrosis

The study found that the overall weighted prevalence of bisphosphonate osteonecrosis (BON) in the cancer population was 6.1%. High-quality studies are needed to accurately characterize the prevalence of BON and to determine effective treatment protocols.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

6.

Osteonecrosis of the jaw induced by clodronate, an alkylbiphosphonate: case report and literature review.

Author: CrépinSabrina, LarocheMarie-Laure, SarryBernard, MerleLouis

Osteonecrosis of the jaw

A case of osteonecrosis of the jaw (ONJ) in a patient treated with clodronate, an alkylbiphosphonate, is reported. This case highlights the risk of ONJ associated with all biphosphonates, including both alkyl- and amino-biphosphonates, particularly with long-term exposure and dental procedures.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

7.

Are the results of multiple drilling and alendronate for osteonecrosis of the femoral head better than those of multiple drilling? A pilot study.

Author: KangPengde, PeiFuxing, ShenBin, ZhouZongke, YangJing

Femoral head preservation
Alendronate risk unclear

This study investigates whether combining multiple drilling core decompression with alendronate, a medication used to treat osteoporosis, is effective in delaying or preventing the progression of osteonecrosis of the femoral head (ONFH) compared to multiple drilling alone.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

8.

Alendronate in the prevention of collapse of the femoral head in nontraumatic osteonecrosis: a two-year multicenter, prospective, randomized, double-blind, placebo-controlled study.

Author: ChenChung-Hwan, ChangJe-Ken, LaiKuo-An, HouSheng-Mou, ChangChih-Hao, WangGwo-Jaw

Reduced THA incidence

Alendronate has been shown to reduce osteoclast activity and may delay the need for total hip arthroplasty (THA) in patients with osteonecrosis of the femoral head. This study aimed to determine the cumulative incidence of THA and time-to-event after alendronate treatment versus placebo.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

9.

Systematic literature review of bisphosphonates and osteonecrosis of the jaw in patients with osteoporosis.

Author: Chamizo CarmonaEugenio, Gallego FloresAdela, Loza SantamaríaEstíbaliz, Herrero OleaAurora, Rosario LozanoMaría Piedad

Osteoporosis treatment
Insufficient evidence
Jaw osteonecrosis risk

There is insufficient evidence to confirm that bisphosphonates used for the treatment of osteoporosis significantly increase the risk of osteonecrosis of the jaw.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

10.

An evidence-based review of risk-reductive strategies for osteonecrosis of the jaws among cancer patients.

Author: KyrgidisAthanassios, TzellosThrasivoulos-George, ToulisKonstantinos, AroraAmit, KouvelasDimitrios, TriaridisStefanos

Reduced ONJ risk

This study examines ways to prevent a serious jaw bone condition (osteonecrosis of the jaws, ONJ) that can occur in cancer patients who take medications to strengthen bones. The study aims to identify specific treatments or strategies that effectively reduce the risk of developing ONJ and to assess how effective these approaches are.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

11.

Outcomes of osseous free flap reconstruction in stage III bisphosphonate-related osteonecrosis of the jaw: systematic review and a new case series.

Author: VercruysseHerman, BackerTom de, MommaertsMaurice Y

Osseous reconstruction for BRONJ
Non-union for BRONJ

This systematic review examined the outcomes of osseous microsurgical reconstruction for Stage III bisphosphonate-related osteonecrosis of the jaw (BRONJ). While reconstruction may offer additional benefits, it carries the risk of non-union and recurrence.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

12.

A systematic review of therapeutical approaches in bisphosphonates-related osteonecrosis of the jaw (BRONJ).

Author: RupelKatia, OttavianiGiulia, GobboMargherita, ContardoLuca, TirelliGiancarlo, VescoviPaolo, Di LenardaRoberto, BiasottoMatteo

BRONJ treatments

The management of bisphosphonate-related osteonecrosis of the jaw (BRONJ) is controversial, with no universally accepted guidelines. This systematic review examines different therapeutic approaches described in the literature to assess their effectiveness.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

13.

Diagnosis and management of osteonecrosis of the jaw: a systematic review and international consensus.

Author: KhanAliya A, MorrisonArchie, HanleyDavid A, FelsenbergDieter, McCauleyLaurie K, O'RyanFelice, ReidIan R, RuggieroSalvatore L, TaguchiAkira, TetradisSotirios, WattsNelson B, BrandiMaria Luisa, PetersEdmund, GuiseTeresa, EastellRichard, CheungAngela M, MorinSuzanne N, MasriBasel, CooperCyrus, MorganSarah L, Obermayer-PietschBarbara, LangdahlBente L, Al DabaghRana, DavisonK Shawn, KendlerDavid L, SándorGeorge K, JosseRobert G, BhandariMohit, El RabbanyMohamed, PierrozDominique D, SulimaniRiad, SaundersDeborah P, BrownJacques P, CompstonJuliet,

ONJ treatment

Osteonecrosis of the jaw (ONJ), a condition where jawbone dies, is associated with medications that slow bone breakdown (bisphosphonates and denosumab). It's more common in cancer patients receiving high doses of these medications. While the exact cause is unknown, inflammation and infection play a role. Preventing ONJ involves addressing oral health problems before starting bone-slowing medications and maintaining good oral hygiene. Treatment depends on the severity and involves antibiotics, surgery, and experimental therapies like bone marrow stem cell transplantation and laser therapy.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

14.

Autologous platelet concentrates for bisphosphonate-related osteonecrosis of the jaw treatment and prevention. A systematic review of the literature.

Author: Del FabbroMassimo, GallesioGiorgia, MozzatiMarco

BRONJ prevention
BRONJ treatment

This systematic review investigates the potential of autologous platelet concentrates (APC) to improve treatment and prevention of bisphosphonate-related osteonecrosis of the jaw (BRONJ).

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

15.

Denosumab and osteonecrosis of the jaw. A systematic analysis of events reported in clinical trials.

Author: Boquete-CastroAna, Gómez-MorenoGerardo, Calvo-GuiradoJosé Luis, Aguilar-SalvatierraAntonio, Delgado-RuizRafael Arcesio

Treat osteonecrosis of the jaw
Osteonecrosis of the jaw

This meta-analysis investigates the relationship between denosumab treatment and the incidence of osteonecrosis of the jaw (ONJ). The review also explores the dosage, timing of first event appearance, and treatment approaches for ONJ related to denosumab.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

16.

Treatment strategies and outcomes of bisphosphonate-related osteonecrosis of the jaw (BRONJ) with characterization of patients: a systematic review.

Author: FliefelR, TröltzschM, KühnischJ, EhrenfeldM, OttoS

BRONJ treatment
Improved BRONJ outcomes
Heterogeneity of studies
Insufficient evidence

This systematic review examines the available treatments and outcomes for bisphosphonate-related osteonecrosis of the jaws (BRONJ).

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

17.

Prevention of medication-related osteonecrosis of the jaws secondary to tooth extractions. A systematic review.

Author: Diniz-FreitasMárcio, LimeresJacobo

ONJ risk

No conclusive scientific evidence is available to date on the efficacy of ONJ prevention protocols in patients treated with antiresorptive or antiangiogenic drugs subjected to tooth extraction.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

18.

Interventions for treating bisphosphonate-related osteonecrosis of the jaw (BRONJ).

Author: RollasonVictoria, LaverrièreAlexandra, MacDonaldLaura C I, WalshTanya, TramèrMartin R, Vogt-FerrierNicole B

Osteoporosis treatment
BRONJ risk

Bisphosphonates are medications used to prevent and treat osteoporosis and bone problems related to cancer. While generally safe, they can cause a rare but serious side effect called osteonecrosis of the jaw (BRONJ), where the jawbone dies. There's no single best treatment for BRONJ, and approaches include oral rinses, antibiotics, surgery, and other therapies.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

19.

Stem Cell Therapy for the Treatment of Hip Osteonecrosis: A 30-Year Review of Progress.

Author: HernigouPhilippe, TrousselierMatthieu, RoubineauFrançois, BouthorsCharlie, ChevallierNathalie, RouardHelene, Flouzat-LachanietteCharles-Henri

Cell therapy for osteonecrosis

Avascular necrosis of the femoral head, a condition where the bone in the hip joint dies, can cause hip collapse, often requiring hip replacement surgery, especially in younger people. This review examined research on the use of stem cell therapy to treat this condition in the early stages, focusing on the progress made over the past 30 years.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

20.

Treatment of osteonecrosis of the jaw related to bisphosphonates and other antiresorptive agents.

Author: Rodriguez-LozanoF-J, Oñate-SánchezR-E

There is no clear consensus on how to manage osteonecrosis of the jaw, a condition that can develop in people taking medications that slow bone breakdown (bisphosphonates and other antiresorptive agents). This study aims to update the guidelines for managing this condition, which were developed by the American Association of Oral and Maxillofacial Surgeons (AAOMS).

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

21.

Effectiveness of treatments for medication-related osteonecrosis of the jaw: A systematic review and meta-analysis.

Author: El-RabbanyMohamed, SgroAdam, LamDavid K, ShahPrakeshkumar S, AzarpazhoohAmir

MRONJ resolution

Surgical treatment of medication-related osteonecrosis of the jaw (MRONJ) was associated with higher odds of complete resolution of the condition compared with medical treatment. High-quality research is required for conclusive statements to be made regarding treatment strategies for management of MRONJ.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

22.

Drug holidays from bisphosphonates and denosumab in postmenopausal osteoporosis: EMAS position statement.

Author: AnagnostisPanagiotis, PaschouStavroula A, MintzioriGesthimani, CeausuIuliana, DepypereHerman, LambrinoudakiIrene, MueckAlfred, Pérez-LópezFaustino R, ReesMargaret, SenturkLevent M, SimonciniTommaso, StevensonJohn C, StutePetra, TrémollieresFlorence A, GoulisDimitrios G

Osteoporosis treatment
AFF risk
ONJ risk

Bisphosphonates and denosumab are commonly used to treat osteoporosis in women after menopause. While they are effective at preventing fractures, the optimal treatment duration is unclear. Side effects like jawbone death (ONJ) and unusual thighbone fractures (AFF) have raised questions about stopping these medications ("drug holiday") after a period of time.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

23.

The Utility of Conservative Treatment Modalities in the Management of Osteonecrosis.

Author: OsmaniFeroz, ThakkarSavyasachi, VigdorchikJonathan

Osteonecrosis treatment

Osteonecrosis is a condition that affects bones and can occur in people of all ages. This review examines the effectiveness of non-surgical treatments for osteonecrosis in the hip and knee, including medications and physical therapies. The focus is on whether non-surgical treatments are a viable alternative to surgery.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

24.

Interventions for managing medication-related osteonecrosis of the jaw.

Author: Beth-TasdoganNatalie H, MayerBenjamin, HusseinHeba, ZolkOliver

Bone destruction
Reduced quality of life

This study discussed medication-related osteonecrosis of the jaw (MRONJ), a severe adverse reaction associated with certain medications used for cancer and osteoporosis, emphasizing its significant morbidity and challenges in treatment.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

25.

Effectiveness of various hip preservation treatments for non-traumatic osteonecrosis of the femoral head: A network meta-analysis of randomized controlled trials.

Author: YuXiao, ZhangDifeng, ChenXianjun, YangJi, ShiLin, PangQingjiang

Improved Harris hip score
Reduced treatment failure
None mentioned

Core decompression (CD) plus cytotherapy was found to be the most effective treatment in reducing treatment failure rates in early and intermediate ONFH patients. Extracorporeal shock wave therapy (ESWT) was most effective in improving Harris hip scores.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

26.

Efficacy of bovine lactoferrin in the post-surgical treatment of patients suffering from bisphosphonate-related osteonecrosis of the jaws: an open-label study.

Author: CalvaniFrancesco, CutoneAntimo, LepantoMaria Stefania, RosaLuigi, ValentiniValentino, ValentiPiera

Improved BRONJ treatment
Shorter wound closure time

Bovine lactoferrin (bLf) significantly reduces wound closure time (1-2 weeks) compared to classical surgical treatment (2-3 months) for patients with bisphosphonate-related osteonecrosis of the jaws (BRONJ).

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

27.

Cell therapy versus simultaneous contralateral decompression in symptomatic corticosteroid osteonecrosis: a thirty year follow-up prospective randomized study of one hundred and twenty five adult patients.

Author: HernigouPhilippe, DuboryArnaud, HommaYasuhiro, GuissouIsaac, Flouzat LachanietteCharles Henri, ChevallierNathalie, RouardHélène

Osteonecrosis treatment

A study of 60 adult patients with osteonecrosis found that autologous bone marrow grafting of the symptomatic hip led to better outcomes than core decompression alone in the contralateral symptomatic hip.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

28.

Microsurgical Reconstruction of the Jaws Using Vascularised Free Flap Technique in Patients with Medication-Related Osteonecrosis: A Systematic Review.

Author: SaccoRoberto, SaccoNicola, HamidUmar, AliSyed Hasan, SinghMark, BlytheJohn St J

Micro-osseous-vascular reconstruction
ONJ treatment

Bone death in the jaw (osteonecrosis of the jaw, ONJ) has been linked to medications like bisphosphonates, denosumab, and antiangiogenic drugs. A procedure to reconstruct the jawbone is a potential treatment option for people with severe ONJ. However, the long-term success of this procedure is still uncertain.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

29.

Systematic review of the use of pentoxifylline and tocopherol for the treatment of medication-related osteonecrosis of the jaw.

Author: Heifetz-LiJiean Joseph, AbdelsamieSamer, CampbellConor B, RothStephanie, FieldingAllen F, MulliganJoseph P

Reduced osteonecrosis

This review evaluates the clinical usefulness of pentoxifylline and tocopherol in treating medication-related osteonecrosis of the jaw (MRONJ).

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

30.

Medication-related osteonecrosis of the jaws (MRONJ) in cancer patients treated with denosumab VS. zoledronic acid: A systematic review and meta-analysis.

Author: LimonesA, Sáez-AlcaideL-M, Díaz-ParreñoS-A, HelmA, BornsteinM-M, Molinero-MourelleP

This study analyzed the incidence, risk ratio (RR), and prognoses of denosumab-related osteonecrosis of the jaws (DRONJ) and Bisphosphonate-Related Osteonecrosis of the Jaws (BRONJ) in cancer patients treated with denosumab or zoledronic acid (ZA).

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

32.

Teriparatide Promotes Bone Healing in Medication-Related Osteonecrosis of the Jaw: A Placebo-Controlled, Randomized Trial.

Author: SimIe-Wen, BorromeoGelsomina L, TsaoClaudine, HardimanRita, HofmanMichael S, Papatziamos HjelleChristian, SiddiqueMusib, CookGary J R, SeymourJohn F, EbelingPeter R

MRONJ treatment

Medication-related osteonecrosis of the jaw (MRONJ) is a rare but serious problem that can happen with certain medications. While good oral hygiene can help prevent MRONJ, treating it once it happens is difficult. Teriparatide, a medication that strengthens bones, has shown promise in studies, potentially offering a new treatment option.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

33.

Autologous platelet concentrates in treatment of medication related osteonecrosis of the jaw.

Author: RusilasHenrikas, BalčiūnaitėAušra, ŽilinskasJuozas

MRONJ treatment

Medication-related osteonecrosis of the jaw (MRONJ) is a serious complication caused by certain medications that results in bone loss in the jaw. It often starts after dental surgery, but gum disease and other chronic inflammation can also increase the risk. There is no standard treatment for MRONJ, but using a patient's own blood platelets (APC) is being explored to promote healing.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

34.

Bisphosphonate-associated osteonecrosis of the jaw.

Author: Ferreira JrLuiz H, Mendonça JrKedson D, Chaves de SouzaJessica, Soares Dos ReisDanyella C, do Carmo Faleiros Veloso GuedesCizelene, de Souza Castro FiliceLetícia, Bruzadelli MacedoSérgio, Soares RochaFlaviana

Treatment options
BRONJ

A systematic review was conducted to determine the possible risk factors related to the pathophysiology of bisphosphonate-related osteonecrosis of the jaw (BRONJ) and identify adequate treatment strategies. The study found that ozone, platelet-rich fibrin (PRF), platelet-rich plasma (PRP)/debridement/laser bio-stimulation, laser surgery, and laser surgery/laser bio-stimulation were promising treatments for BRONJ.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

35.

Adjuvant therapies for MRONJ: A systematic review.

Author: GovaertsDries, PiccartFrederik, OckermanAnna, CoropciucRuxandra, PolitisConstantinus, JacobsReinhilde

MRONJ treatment

This study reviews research on different treatments for medication-related osteonecrosis of the jaw (MRONJ), a serious condition that can occur as a side effect of certain medications. The focus is on comparing the effectiveness of different additional therapies that are used alongside standard medical and surgical treatments to promote healing.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

36.

Treatment of medication-related osteonecrosis of the jaw (MRONJ). A systematic review.

Author: GokerF, GrecchiE, GrecchiF, FrancettiL, Del FabbroM

MRONJ treatment

Medication-related osteonecrosis of the jaw (MRONJ) is a serious side effect from certain medications that causes bone loss in the jaw. There are many different treatments, ranging from simple care to more invasive surgeries, sometimes combined with other therapies. This review will assess how well these treatments work for MRONJ.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

37.

The Treatment of Medication-Related Osteonecrosis of the Jaw (MRONJ): A Systematic Review with a Pooled Analysis of Only Surgery versus Combined Protocols.

Author: Di FedeOlga, CanepaFederica, PanzarellaVera, MauceriRodolfo, Del GaizoCarmine, BedogniAlberto, FuscoVittorio, TozzoPietro, PizzoGiuseppe, CampisiGiuseppina, GalvanoAntonio

Combined surgery
Conservative surgery
MRONJ treatment

This systematic review and pooled analysis investigated the efficacy of surgical techniques for medication-related osteonecrosis of the jaw (MRONJ). Combined conservative surgery with non-invasive procedures showed a significant improvement rate at 6 months compared to aggressive surgery alone. While total resolution rates were similar, conservative surgery combined with adjuvants like ozone, LLLT, or blood components achieved partial or full healing in all stages. More research is needed to confirm these findings.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

38.

Surgical vs conservative treatment of medication-related osteonecrosis of the jaw: A complex systematic review and meta-analysis.

Author: LobekkOle Kristian, DijkstraWard, PedersenTorbjørn Ø

Osteonecrosis of the jaw treatment
Lack of standardized treatment protocols

This systematic review compared the outcome of surgical and conservative treatment approaches for medication-related osteonecrosis of the jaw. The results showed slightly better outcomes after surgical treatment, particularly for advanced disease stages. However, the quality of evidence was poor, and further research is needed to establish standardized treatment protocols and outcome measures.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

39.

Interventions for managing medication-related osteonecrosis of the jaw.

Author: Beth-TasdoganNatalie H, MayerBenjamin, HusseinHeba, ZolkOliver, PeterJens-Uwe

MRONJ treatment

Medication-related osteonecrosis of the jaw (MRONJ) is a serious complication that can occur in some people taking medications for cancer and osteoporosis. This condition involves bone damage in the jaw, leading to significant pain, difficulty eating, and other problems. The risk of MRONJ varies depending on the medication used, the dose, and how long it's taken. This updated review examines MRONJ and its management.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

40.

Does Adjunction of Autologous Osteoblastic Cells Improve the Results of Core Decompression in Early-stage Femoral Head Osteonecrosis? A Double-blind, Randomized Trial.

Author: JayankuraMarc, ThomasThierry, SeefriedLothar, DubranaFrederic, GüntherKlaus-Peter, RondiaJean, DavisEdward T, Winnock de GravePhilip, CarronPhilippe, GangjiValérie, Vande BergBruno, GodeauxOlivier, SonnetWendy

ONFH treatment efficacy

This study aims to confirm the efficacy of core decompression of the femoral head combined with cell therapies in patients with early-stage ONFH.

Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Clinical Trial, Phase IIIA Phase III trial is a trial that further rigorously verifies the efficacy and safety of a new drug or treatment, whose efficacy and safety have been confirmed in a Phase II trial, in a large number of patients, and evaluates whether it is superior to existing treatments.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

41.

Surgical treatment methods of medication-related osteonecrosis of the jaw. A systematic review.

Author: ZigmantavičiusJonas, KilinskaitėGerda, KubiliusRičardas

Improved bone and mucosa healing
Osteonecrosis recurrence

This systematic review aims to compare the effectiveness of different surgical treatments for medication-related osteonecrosis of the jaw, including the use of autologous platelet concentrates and fluorescence guidance. The goal is to improve bone and mucosa healing, reduce the risk of osteonecrosis recurrence, and identify the best surgical approach.

Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

42.

In Vitro Cytotoxicity of Antiresorptive and Antiangiogenic Compounds on Oral Tissues Contributing to MRONJ: Systematic Review.

Author: GuirguisRobert H, TanLeonard P, HicksRebecca M, HasanAniqa, DuongTina D, HuXia, HngJordan Y S, HadiMohammad H, OwuamaHenry C, MatthyssenTamara, McCulloughMichael, CanforaFederica, PaoliniRita, CelentanoAntonio

Cell death
MRONJ

Antiresorptive and antiangiogenic drugs were shown to have cytotoxic effects in a dose- and time-dependent manner in oral cells. These effects include decreases in cell proliferation, viability, and migration. Further research is required to fully understand the role of these drugs in the development of medication-related osteonecrosis of the jaw (MRONJ).

Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

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