Clinical Performance of Implant-Supported Prostheses in the Rehabilitation of Patients Previously Treated for Medication-Related Osteonecrosis of the Jaws (MRONJ): A Systematic Review

Overview

Journal Cureus

Specialty Biomedical Engineering

Date 2024 Jul 5

PMID 38966469

Authors

Eduardo Anitua

Mohammad Alkhraisat

Asier Eguia

Affiliations

Soon will be listed here.

Abstract

There is a lack of consensus on managing resultant bone and soft tissue defects or on restoring oral function and aesthetics following medication-related osteonecrosis of the jaws (MRONJ) lesion healing. This clinical challenge presents a dilemma for practitioners. Removable prostheses pose a recurrence risk if poorly fitted and may inadequately restore function or aesthetics in cases of significant bone defect. Dental implant-supported prostheses could enhance function and quality of life, though their risks and indications are not well-defined. This systematic review examines the clinical outcomes and complications associated with implant-supported rehabilitations post-MRONJ surgery. This study was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement recommendations and it was pre-registered in the Prospective Register of Systematic Reviews (PROSPERO) (CRD42023492539).

Citing Articles

Critical Analysis of the Effect of Antiresorptive Drugs on Osteonecrosis Associated With Dental Implants: An Umbrella Review.

Dahiya M, Dhawan P, Rani S, Saxena V Cureus. 2024; 16(10):e71506.

PMID: 39552988 PMC: 11563775. DOI: 10.7759/cureus.71506.

References

Goker F, Grecchi E, Fabbro M, Longoni S, Stefanelli L, Grecchi F . Zygomatic Implant Insertion in MRONJ: A Case Report with a Follow-Up of 3 Years. J Clin Med. 2023; 12(9). PMC: 10179021. DOI: 10.3390/jcm12093300. View

Caggiano M, Di Spirito F, Acerra A, Galdi M, Sisalli L . Multiple-Drugs-Related Osteonecrosis of the Jaw in a Patient Affected by Multiple Myeloma: A Case Report. Dent J (Basel). 2023; 11(4). PMC: 10137621. DOI: 10.3390/dj11040104. View

Guyatt G, Oxman A, Vist G, Kunz R, Falck-Ytter Y, Alonso-Coello P . GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ. 2008; 336(7650):924-6. PMC: 2335261. DOI: 10.1136/bmj.39489.470347.AD. View

Hjortholt C, Andersen S, Jensen S, Kofod T, Gotfredsen K . Dental implant treatment in patients with cancer on high-dose antiresorptive medication: A prospective feasibility study with 2 years follow-up. Clin Oral Implants Res. 2023; 35(1):63-76. DOI: 10.1111/clr.14197. View

Kim J, Baik J, Jeon J . Dental implant treatment after healing of bisphosphonate-related osteonecrosis of the jaw (BRONJ) in the same region: a case report. J Korean Assoc Oral Maxillofac Surg. 2016; 42(3):157-61. PMC: 4940201. DOI: 10.5125/jkaoms.2016.42.3.157. View

Halpern L, Adams D . Treatment of Medication-Related Osteonecrosis of the Jaw: Controversies in Causality and Therapy. Dent Clin North Am. 2023; 68(1):67-85. DOI: 10.1016/j.cden.2023.07.005. View

Nicolatou-Galitis O, Schiodt M, Amaral Mendes R, Ripamonti C, Hope S, Drudge-Coates L . Medication-related osteonecrosis of the jaw: definition and best practice for prevention, diagnosis, and treatment. Oral Surg Oral Med Oral Pathol Oral Radiol. 2018; 127(2):117-135. DOI: 10.1016/j.oooo.2018.09.008. View

Munn Z, Barker T, Moola S, Tufanaru C, Stern C, McArthur A . Methodological quality of case series studies: an introduction to the JBI critical appraisal tool. JBI Evid Synth. 2020; 18(10):2127-2133. DOI: 10.11124/JBISRIR-D-19-00099. View

Ebell M, Siwek J, Weiss B, Woolf S, Susman J, Ewigman B . Strength of recommendation taxonomy (SORT): a patient-centered approach to grading evidence in the medical literature. J Am Board Fam Pract. 2004; 17(1):59-67. DOI: 10.3122/jabfm.17.1.59. View

10.

Chen J, Wu C, Gallagher K, Wang C . Revisiting best practice guidelines and patient care workflow for managing the risk of medication-related osteonecrosis of the jaw: comparative summary and case studies. Quintessence Int. 2023; 54(10):832-843. DOI: 10.3290/j.qi.b4213007. View

11.

El-Rabbany M, Blanas N, Sutherland S, Lam D, Shah P, Azarpazhooh A . Surgical Therapy in Patients With Medication-Related Osteonecrosis of the Jaw Is Associated With Disease Resolution and Improved Quality of Life: A Prospective Cohort Study. J Oral Maxillofac Surg. 2022; 80(6):1084-1093. DOI: 10.1016/j.joms.2022.01.012. View

12.

Ferrari S, Bianchi B, Savi A, Poli T, Multinu A, Balestreri A . Fibula free flap with endosseous implants for reconstructing a resected mandible in bisphosphonate osteonecrosis. J Oral Maxillofac Surg. 2008; 66(5):999-1003. DOI: 10.1016/j.joms.2007.06.631. View

13.

Kover Z, Ban A, Gajdacs M, Polgar B, Urban E . Role of Actinomyces spp. and related organisms in the development of medication-related osteonecrosis of the jaw (MRONJ): Clinical evidence based on a case series. Eur J Microbiol Immunol (Bp). 2023; 13(4):125-134. PMC: 10755666. DOI: 10.1556/1886.2023.00041. View

14.

Ciobanu G, Mogoanta L, Camen A, Ionescu M, Vlad D, Staicu I . Clinical and Histopathological Aspects of MRONJ in Cancer Patients. J Clin Med. 2023; 12(10). PMC: 10219482. DOI: 10.3390/jcm12103383. View

15.

Lee J, Park J, Lee S . Successful New Dental Implant Installation in a Healed Site of Medication-Related Osteonecrosis of the Jaw: A Case Report. J Oral Implantol. 2023; 49(2):117-123. DOI: 10.1563/aaid-joi-D-20-00295. View

16.

Zhang J, Liu Z, Qiu J, Yang J . Impact of locally delivered diphosphonates on dental implants: A systematic review and meta-analysis. J Stomatol Oral Maxillofac Surg. 2023; 124(6S):101521. DOI: 10.1016/j.jormas.2023.101521. View

17.

Kawahara M, Kuroshima S, Sawase T . Clinical considerations for medication-related osteonecrosis of the jaw: a comprehensive literature review. Int J Implant Dent. 2021; 7(1):47. PMC: 8119587. DOI: 10.1186/s40729-021-00323-0. View

18.

Bagan L, Jimenez Y, Leopoldo M, Murillo-Cortes J, Bagan J . Exposed necrotic bone in 183 patients with bisphosphonate-related osteonecrosis of the jaw: Associated clinical characteristics. Med Oral Patol Oral Cir Bucal. 2017; 22(5):e582-e585. PMC: 5694180. DOI: 10.4317/medoral.22133. View

19.

Zhao N, Li Q, Wang Y, Qiao Q, Huang H, Guo C . Anti-angiogenic drug aggravates the degree of anti-resorptive drug-based medication-related osteonecrosis of the jaw by impairing the proliferation and migration function of gingival fibroblasts. BMC Oral Health. 2023; 23(1):330. PMC: 10225109. DOI: 10.1186/s12903-023-03034-7. View

20.

Marx R . Pamidronate (Aredia) and zoledronate (Zometa) induced avascular necrosis of the jaws: a growing epidemic. J Oral Maxillofac Surg. 2003; 61(9):1115-7. DOI: 10.1016/s0278-2391(03)00720-1. View