Ein Update der Medikamenten-assoziierten Kiefernekrose

Die medikamentenassoziierte Kiefernekrose (MRONJ) ist eine Erkrankung des Kieferknochens, die unter Einnahme von antiresorptiver Therapie oder Denosumab auftreten kann. Diese äußert sich in Schmerzen, Infektionen bis hin zu pathologischen Frakturen. Je nach Verlauf und Ausmaß können Kiefernekrosen erhebliche Auswirkungen auf die Lebensqualität haben. Die endgültige Pathogenese dieser Erkrankung ist noch nicht geklärt. Im Folgenden soll dieses seltene, aber doch schwerwiegende Krankheitsbild näher betrachtet werden.

• Literatur

• 1 Jara MA, Varghese J, Hu MI. Adverse events associated with bone-directed therapies in patients with cancer. Bone 2022; 158: 115901
• 2 Bansal H. Medication-related osteonecrosis of the jaw: an update. Natl J Maxillofac Surg 2022; 13: 5-10
• 3 Ruggiero SL, Dodson TB, Aghaloo T. et al. American Association of Oral and Maxillofacial Surgeons’ Position Paper on Medication-Related Osteonecrosis of the Jaws-2022 Update. J Oral Maxillofac Surg 2022; 80: 920-943
• 4 Aghaloo TL, Felsenfeld AL, Tetradis S. Osteonecrosis of the jaw in a patient on Denosumab. J Oral Maxillofac Surg 2010; 68: 959-963
• 5 Migliorati CA, Mattos K, Palazzolo MJ. How patients' lack of knowledge about oral bisphosphonates can interfere with medical and dental care. J Am Dent Assoc 2010; 141: 562-566
• 6 van Cann T, Loyson T, Verbiest A. et al. Incidence of medication-related osteonecrosis of the jaw in patients treated with both bone resorption inhibitors and vascular endothelial growth factor receptor tyrosine kinase inhibitors. Support Care Cancer 2018; 26: 869-878
• 7 Otto S, Pautke C, Van den Wyngaert T. et al. Medication-related osteonecrosis of the jaw: Prevention, diagnosis and management in patients with cancer and bone metastases. Cancer Treat Rev 2018; 69: 177-187
• 8 Nicolatou-Galitis O, Schiødt M, Mendes RA. et al. Medication-related osteonecrosis of the jaw: definition and best practice for prevention, diagnosis, and treatment. Oral Surg Oral Med Oral Pathol Oral Radiol 2019; 127: 117-135
• 9 Obermeier KT, Dewenter I, Malenova Y. et al. Sclerotic bone: a sign of bone reaction in patients with medication related osteonecrosis of the jaw. Sci Rep 2024; 14: 7914
• 10 Barragan-Adjemian C, Lausten L, Ang DB. et al. Bisphosphonate-related osteonecrosis of the jaw: model and diagnosis with cone beam computerized tomography. Cells Tissues Organs 2009; 189: 284-288
• 11 Bamias A, Kastritis E, Bamia C. et al. Osteonecrosis of the jaw in cancer after treatment with bisphosphonates: incidence and risk factors. J Clin Oncol 2005; 23: 8580-8587
• 12 Otto S, Hafner S, Mast G. et al. Bisphosphonate-related osteonecrosis of the jaw: is pH the missing part in the pathogenesis puzzle?. J Oral Maxillofac Surg 2010; 68: 1158-1161
• 13 Lesclous P, Abi Najm S, Carrel JP. et al. Bisphosphonate-associated osteonecrosis of the jaw: a key role of inflammation?. Bone 2009; 45: 843-852
• 14 Ristow O, Otto S, Troeltzsch M. et al. Treatment perspectives for medication-related osteonecrosis of the jaw (MRONJ). J Craniomaxillofac Surg 2015; 43: 290-293
• 15 Hafner S, Ehrenfeld M, Storz E. et al. Photodynamic Inactivation of Actinomyces naeslundii in Comparison With Chlorhexidine and Polyhexanide--A New Approach for Antiseptic Treatment of Medication-Related Osteonecrosis of the Jaw?. J Oral Maxillofac Surg 2016; 74: 516-522
• 16 Pautke C, Bauer F, Otto S. et al. Fluorescence-guided bone resection in bisphosphonate-related osteonecrosis of the jaws: first clinical results of a prospective pilot study. J Oral Maxillofac Surg 2011; 69: 84-91
• 17 El-Rabbany M, Blanas N, Sutherland S. et al. Development and evaluation of the clinimetric properties of the Medication-Related Osteonecrosis of the Jaw Quality of Life Questionnaire (MRONJ-QoL). Int J Oral Maxillofac Surg 2022; 51: 768-775