What are the stages of ONJ?

What are the stages of ONJ?

proposed an ONJ classification comprising three stages (31): stage 1 = bone exposure but without signs or symptoms of infection; stage 2 = bone exposure/necrosis with clinical evidence of infection; stage 3 = the above manifestations and also alterations such as pathological fractures, extraoral fistulas or osteolysis …

Do all bisphosphonates cause osteonecrosis?

Low-dose bisphosphonate use in patients with osteoporosis or other metabolic bone disease has not been causally linked to the development of osteonecrosis of the jaw. Bisphosphonates have been widely used in the management of osteoporosis and metabolic bone disease.

What is bisphosphonate related osteonecrosis?

Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is a condition in which bones of the maxillofacial skeleton, in particular the tooth-bearing areas, become necrotic and exposed to the oral cavity.

Why do bisphosphonates cause MRONJ?

The risk of a patient having MRONJ after discontinuing this medication is unknown. There are suggestions that bisphosphonate may inhibit the proliferation of soft tissue cells and increases apoptosis. This may result in delayed soft tissue healing.

How do you treat osteonecrosis of the jaw?

Treatment of osteonecrosis of the jaw typically involves scraping away some of the damaged bone, taking antibiotics by mouth, and using mouth rinses. After treatment, people should follow up with the oral surgeon who will evaluate healing and ensure the area is being kept clean with proper oral hygiene.

How do you prevent osteonecrosis of the jaw?

There is no known prevention of ONJ. However, to reduce the risk, all patients taking bisphosphonates should get regular dental checkups.

How does bisphosphonates treat osteoporosis?

Bisphosphonates slow bone resorption by reducing osteoclast function. Many studies have shown that this class of medication can improve bone density and reduce the risk of fracture in patients with a reduced bone density.

How many cases of osteonecrosis are there?

Affected Populations Osteonecrosis usually affects people between 30 and 50 years of age; about 10,000 to 20,000 people develop osteonecrosis each year in the United States. Osteonecrosis affects both men and women and affects people of all ages. It is most common among people in their thirties and forties.

How is Mronj diagnosed?

A patient can be diagnosed with MRONJ if both of the following criteria are fulfilled: a history or ongoing treatment with antiangiogenic agents or antiresorptives such as bisphosphonate and denosumab; exposed or nonhealing bone that can be probed through a fistula in the maxillofacial region persisting for more than …

What do bisphosphonates do?

Bisphosphonates are drugs that target areas of higher bone turnover. The osteoclast cells, which break down old bone, absorb the bisphosphonate drug. Their activity is slowed down. This reduces bone breakdown.

What is the risk of MRONJ?

The risk of MRONJ is greater in patients receiving high-dose BMAs (usually for metastatic bone disease) than in those receiving low-dose BMAs (usually for osteoporosis), with a reported incidence of 1–9% [2] and 0.10% [8], respectively.

How is MRONJ diagnosed?

According to the AAOMS, imaging is critical in the diagnosis and assessment of disease progression in MRONJ patients. Orthopantomography, CT scanning and MRI are most commonly used to diagnose MRONJ.