Effectiveness of the different treatments for medication-related osteonecrosis of the jaws in young players

ABSTRACT

Medication-related-osteonecrosis of the jaw, MRONJ, is a severe iatrogenic condition. Patients receiving certain types of medications related to the inhibition of osteoclast function may have an increased risk of developing bone necrosis. The overall prevalence of MRONJ is low, and the current treatment methods include antibiotics and surgical intervention. Objective: The main purpose is to compare the effectiveness of different contemporary treatment modalities in relation to MRONJ. Material and methods: A systematic electronic search was performed mainly using Pubmed. After adjustment of the exclusion criteria, a total of 21 articles were selected for this review. Result: The overall success rate for conservative treatment ranged from 0% to 33%, whereas surgical therapy had an overall success rate of 88.57% to 100%. Success rate for adjunctive treatment, including teriparatide, fluorescence guided surgery, low-level laser therapy, and leukocyte- and platelet-rich-fibrine ranged from 5.17% to 99.4%. Conclusion: The chances of achieving complete healing with purely conservative treatments are low. Regardless of MRONJ stage, early surgical treatment can achieve better success rates and prevent disease deterioration. The recent introduction of adjunctive treatments can accelerate bone healing and improve patient morbidity, although more evidence is still needed to confirm which treatment achieves the highest success rates. (AU)