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An Update and Systematic Review of the Effects of Antiangiogenic Medications on Osteonecrosis of the Jaw



Zandi S1 ; Nomani M1 ; Amin HR2 ; Azadbakht M1
Authors
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Authors Affiliations
  1. 1. Resident of Oral and Maxillofacial Surgery, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. General Dentist, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Source: Pakistan Journal of Medical and Health Sciences Published:2020

Abstract

Background: Medication-related osteonecrosis of the jaw (MRONJ) has recently emerged as a side effect of agents used to prevent angiogenesis or bone complications. The present review aimed to investigate the association of antiangiogenic medications with osteonecrosis of the jaw. Methods: Data was collected using key words including osteonecrosis, jaw, medication, antiangiogenic, bisphosphonates (BPs), Denosumab, Bevacizumab, Cabozantinib, Sunitinib and jaw disease in international databases including PubMed, Scopus, Web of Science, Cochrane and Embase from 2010 to 2020. All the references were checked manually. After entering articles based on inclusion and exclusion criteria, the main information was extracted from the studies. Results: 43 studies were classified and entry the systematic review. The range of the subjects age was 38-90 years. The antiangiogenic drugs used in this study included BPs (zoldronic acid, alendronic acid, Ibandronate, Risedronate, Pamidronate, coldronate), Denosumab, Bevacizumab, Sunitinib and Cabozantinib.The maximum and minimum drugs course of treatment in these studies were 15 years and one week, respectively.Also, the min and max periods, from drug discontinuation to the patient's full recovery, was 3 and 30 months, respectively. The largest number of studies reported stage 2 MRONJ and also the most prevalent MRONJ was observed in the mandibular bone area. In 28 studies, patients with MRONJ were successfully treated. Conclusion: Since antiangiogenic medications are causing osteonecrosis of the jawbone, it is recommended that patients treated with these medications always be followed up, and the diagnostic tests be done to provide their diagnosis in an earlier stage of ONJ. © 2020 Lahore Medical And Dental College. All rights reserved.
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