Review Note
Last Update: 04/25/2024 02:38 AM
Current Deck: DOH256 - Foundations of Dental Clinical Practice 2::Medical History #2
PublishedCurrently Published Content
Front
Medication related osteonecrosis of
the jaws (MRONJ)
What
is the history taking process for a patient at risk of MRONJ?
Back
History taking to assess the risk of medication-related osteonecrosis of the jaw
Has the patient ever received treatment for any bone or calcium disorders or malignancy?
Antiresorptive drugs are used to treat:
- osteoporosis
- Paget disease of the bone
- cancer with spread to the bone (eg breast, prostate, liver, lung, kidney)
- multiple myeloma.
Romosozumab is used to treat osteoporosis.
Is the patient currently receiving or have they previously received treatment with an antiresorptive drug or romosozumab?
Antiresorptive drugs can be taken orally (either daily, once weekly or once monthly), or can be administered intravenously or subcutaneously and given less frequently (eg once or twice yearly). Antiresorptive drugs available in Australia are:
- alendronate
- denosumab
- ibandronic acid
- pamidronate
- risedronate
- zoledronic acid.
Romosozumab is given subcutaneously once monthly.
Has the patient received an antiangiogenic drug for the management of cancer?
Antiangiogenic drugs are used as targeted therapies for specific cancers. Some antiangiogenic drugs (cabozantinib, lenvatinib, sunitinib [tyrosine kinase inhibitors] and bevacizumab [a monoclonal antibody-targeting VEGF]) have been associated with an increased risk of medication-related osteonecrosis of the jaw; the risk may also be increased with other drugs that have a similar mechanism of action.
If the patient has received any of the treatments above, see
Figure 13.33 for further risk assessment.
VEGF = vascular endothelial growth factorNo published tags.
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