Management of medication-related osteonecrosis of the jaw: An overview of national and international guidelines

Patel, Nikul ORCID: https://orcid.org/0009-0005-7452-7694 and Seoudi, Noha 2024. Management of medication-related osteonecrosis of the jaw: An overview of national and international guidelines. British Journal of Oral and Maxillofacial Surgery 62 (10) , pp. 899-908. 10.1016/j.bjoms.2024.08.008

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Abstract

There is variability amongst clinicians in the management of medication-related osteonecrosis of the jaw (MRONJ) though numerous guidelines are available. The aim of this critical review is to appraise current international and national guidelines on MRONJ to evaluate areas of consensus or inconsistency, identify areas lacking evidence, and discuss recommendations with agreement and variability across guidelines. A literature search was performed to identify all national and international guidelines published until May 2022 on the prevention and treatment of MRONJ. Included guidelines were compared and critically appraised with Appraisal of Guidelines for Research and Evaluation II (AGREE II). The included sixteen guidelines were published from ten different countries, two of which had international collaborations. AGREE II assessment found four guidelines of high quality. There is consensus to optimise oral health prior to and during therapy, to conservatively manage established MRONJ in earlier stages and consider surgery at advanced stages. There is disparity on strategies to reduce the risk of osteonecrosis such as the avoidance of invasive dental procedures, therapy suspension, and techniques to reduce the impact of invasive surgery. The authors recommend an international lead in the development of dental guidelines to establish a global standardised management approach aiming for better health equality.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Dentistry
Publisher:	Elsevier
ISSN:	0266-4356
Date of First Compliant Deposit:	3 October 2024
Date of Acceptance:	31 August 2024
Last Modified:	15 Jan 2025 11:00
URI:	https://orca.cardiff.ac.uk/id/eprint/172559

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