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ORIGINAL ARTICLE
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J Korean Dent Assoc. 2023;61(7):444-459. Published online June 30, 2023.
DOI: https://doi.org/10.22974/jkda.2023.61.7.001
- 약물관련 골괴사(MRONJ) 치료권고안, 무엇이 달라졌나?
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권대근
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경북대학교 치과대학 구강악안면외과학교실
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- Position Papers on MRONJ(Medication related osteonecrosis of the jaw), What has changed?
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Tae-Geon Kwon
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Dept. of Oral and Maxillofacial Surgery, School of Dentistry, Kyungpook National University
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- Corresponding author: Tae-Geon Kwon Email: kwondk@knu.ac.kr
- Received: March 27, 2023; Revised: April 3, 2023 Accepted: June 1, 2023.
- Abstract
- Antiresorptives, such as bisphosphonate, denosumab, are widely prescribed drugs for the treatment of osteoporosis, os-teopenia, malignant bone metastases, multiple myeloma and Paget`s disease. They have therapeutic efficacy for controlling bone pain and reducing skeletal related events including the pathologic fractures. However, it was reported that the develop-ment of osteonecrosis of the jaw(ONJ) could be related to antiresorptive treatments. It was first defined as Bisphosphonate-related osteonecrosis of the jaw in 2007 American Association of Oral and Maxillofacial Surgeons(AAOMS) position paper. This was changed to Medication-related osteonecrosis of the jaw(MRONJ) in the AAOMS position paper 2014. This
position paper was updated recently in May 2022 and contains revisions to disease definition and management strategies at “AAOMS position paper on MRONJ-2022 update”. The important changes in clinical implications are as follows; 1) In the definition, immune modulators (such as Romosozumab) were included with potential medications related with osteo-necrosis of the jaw (ONJ), 2) Operative therapy was included for all stages (1, 2 and 3) in treatment strategies, 3) Formerly mentioned drug holiday before surgical procedure to prevent MRONJ was not identified in 2022 AAOMS position paper. Most of the statements in AAOMS 2022 position paper were based on strict literature reviews and changes were made if there is little evidence to suggest the specific diagnosis or therapeutic options. Understanding the changes compared to the previous position papers is important in selecting adequate treatment strategies for MRONJ.
Keywords :MRONJ, bisphosphonate; denosumab; antiresorptive agent; position paper
