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Medication-Related Osteonecrosis of the Jaws (MRONJ) in Children and Young Patients—A Systematic Review
Medication-related osteonecrosis of the jaw (MRONJ) is defined by the American Association of Oral and Maxillofacial Surgeons (AAOMS) as the presence of an exposed bone area in the maxillofacial region, present for more than eight weeks in patients treated with the use of antiresorptive or antiangio...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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MDPI
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9962332/ https://www.ncbi.nlm.nih.gov/pubmed/36835951 http://dx.doi.org/10.3390/jcm12041416 |
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author | Rosales, Hemil Dario Garcia Guevara, Henry Requejo, Stefania Jensen, Maria Dianella Acero, Julio Olate, Sergio |
author_facet | Rosales, Hemil Dario Garcia Guevara, Henry Requejo, Stefania Jensen, Maria Dianella Acero, Julio Olate, Sergio |
author_sort | Rosales, Hemil Dario |
collection | PubMed |
description | Medication-related osteonecrosis of the jaw (MRONJ) is defined by the American Association of Oral and Maxillofacial Surgeons (AAOMS) as the presence of an exposed bone area in the maxillofacial region, present for more than eight weeks in patients treated with the use of antiresorptive or antiangiogenic agents, with no history of radiation or metastatic disease. Bisphosphonates (BF) and denosumab (DS) are widely used in adults for the management of patients with cancer and osteoporosis, and recently there has been an increase in their use in child and young patients for the management of disorders such as osteogenesis imperfecta (OI), glucocorticoid-induced osteoporosis, McCune-Albright syndrome (MAS), malignant hypercalcemia, and others. There are differences between case reports in adults compared to child and young patients related to the use of antiresorptive/antiangiogenic drugs and the development of MRONJ. The aim was to analyze the presence of MRONJ in children and young patients, and the relation with oral surgery. A systematic review, following the PRISMA search matrix based on the PICO question, was conducted in PubMed, Embase, ScienceDirect, Cochrane, Google Scholar, and manual search in high-impact journals between 1960 and 2022, publications in English or Spanish, including randomized and non-randomized clinical trials, prospective and retrospective cohort studies, cases and controls studies, and series and case reports. A total of 2792 articles were identified and 29 were included; all of them published between 2007 and 2022, identifying 1192 patients, 39.68% male and 36.24% female, aged 11.56 years old on average, using these drugs mainly for OI (60.15%); 4.21 years on average was the therapy time and 10.18 drug doses administered on average; oral surgery was observed in 216 subjects, reporting 14 cases of MRONJ. We concluded that there is a low presence of MRONJ in the child and youth population treated with antiresorptive drugs. Data collection is weak, and details of therapy are not clear in some cases. Deficiencies in protocols and pharmacological characterization were observed in most of the included articles. |
format | Online Article Text |
id | pubmed-9962332 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-99623322023-02-26 Medication-Related Osteonecrosis of the Jaws (MRONJ) in Children and Young Patients—A Systematic Review Rosales, Hemil Dario Garcia Guevara, Henry Requejo, Stefania Jensen, Maria Dianella Acero, Julio Olate, Sergio J Clin Med Review Medication-related osteonecrosis of the jaw (MRONJ) is defined by the American Association of Oral and Maxillofacial Surgeons (AAOMS) as the presence of an exposed bone area in the maxillofacial region, present for more than eight weeks in patients treated with the use of antiresorptive or antiangiogenic agents, with no history of radiation or metastatic disease. Bisphosphonates (BF) and denosumab (DS) are widely used in adults for the management of patients with cancer and osteoporosis, and recently there has been an increase in their use in child and young patients for the management of disorders such as osteogenesis imperfecta (OI), glucocorticoid-induced osteoporosis, McCune-Albright syndrome (MAS), malignant hypercalcemia, and others. There are differences between case reports in adults compared to child and young patients related to the use of antiresorptive/antiangiogenic drugs and the development of MRONJ. The aim was to analyze the presence of MRONJ in children and young patients, and the relation with oral surgery. A systematic review, following the PRISMA search matrix based on the PICO question, was conducted in PubMed, Embase, ScienceDirect, Cochrane, Google Scholar, and manual search in high-impact journals between 1960 and 2022, publications in English or Spanish, including randomized and non-randomized clinical trials, prospective and retrospective cohort studies, cases and controls studies, and series and case reports. A total of 2792 articles were identified and 29 were included; all of them published between 2007 and 2022, identifying 1192 patients, 39.68% male and 36.24% female, aged 11.56 years old on average, using these drugs mainly for OI (60.15%); 4.21 years on average was the therapy time and 10.18 drug doses administered on average; oral surgery was observed in 216 subjects, reporting 14 cases of MRONJ. We concluded that there is a low presence of MRONJ in the child and youth population treated with antiresorptive drugs. Data collection is weak, and details of therapy are not clear in some cases. Deficiencies in protocols and pharmacological characterization were observed in most of the included articles. MDPI 2023-02-10 /pmc/articles/PMC9962332/ /pubmed/36835951 http://dx.doi.org/10.3390/jcm12041416 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Review Rosales, Hemil Dario Garcia Guevara, Henry Requejo, Stefania Jensen, Maria Dianella Acero, Julio Olate, Sergio Medication-Related Osteonecrosis of the Jaws (MRONJ) in Children and Young Patients—A Systematic Review |
title | Medication-Related Osteonecrosis of the Jaws (MRONJ) in Children and Young Patients—A Systematic Review |
title_full | Medication-Related Osteonecrosis of the Jaws (MRONJ) in Children and Young Patients—A Systematic Review |
title_fullStr | Medication-Related Osteonecrosis of the Jaws (MRONJ) in Children and Young Patients—A Systematic Review |
title_full_unstemmed | Medication-Related Osteonecrosis of the Jaws (MRONJ) in Children and Young Patients—A Systematic Review |
title_short | Medication-Related Osteonecrosis of the Jaws (MRONJ) in Children and Young Patients—A Systematic Review |
title_sort | medication-related osteonecrosis of the jaws (mronj) in children and young patients—a systematic review |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9962332/ https://www.ncbi.nlm.nih.gov/pubmed/36835951 http://dx.doi.org/10.3390/jcm12041416 |
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