Rodriguez-Lozano F-J, Oñate-Sánchez R-E
Clínica Odontológica Universitaria, Unidad Pacientes Especiales y Gerodontología, University of Murcia, IMIB-Arrixaca. Morales Meseguer Hospital, Avda. Marqués de los Vélez s/n, 30007- Murcia, Spain,
Med Oral Patol Oral Cir Bucal. 2016 Sep 1;21(5):e595-600. doi: 10.4317/medoral.20980.
The clinical management of medication-related osteonecrosis of the jaw (MRONJ) in patients treated with bisphosphonates and other antiresorptive agents is subject to controversy. The American Association of Oral and Maxillofacial Surgeons (AAOMS) has developed guidelines for the correct management of the disorder which are revised and updated by a panel of experts.
The present systematic review analyzes the different treatments currently used to treat this clinical condition, based on the PRISMA® (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement published in 2009. An electronic Medline search was made of the PubMed database, covering the period 2006-2014. The last search date was 31 December 2014.
A total of 29 articles were selected from the initial search according to the different drugs implicated in the appearance of osteonecrosis; the treatment modality used according to the stage of the disease; and the recorded success rate.
It is currently still recommended that the management of MRONJ should be decided according to the stage of the disease - conservative treatment being preferred in early stages without symptoms, while surgical management is preferred in the case of bone exposure with symptoms.
双膦酸盐及其他抗吸收剂治疗患者的药物性颌骨坏死（MRONJ）的临床管理存在争议。美国口腔颌面外科医师协会（AAOMS）制定了该疾病的正确管理指南，由专家小组进行修订和更新。
本系统评价基于2009年发表的PRISMA®（系统评价和Meta分析的首选报告项目）声明，分析了目前用于治疗这种临床病症的不同治疗方法。对PubMed数据库进行了电子Medline检索，涵盖2006 - 2014年期间。最后检索日期为2014年12月31日。
根据与骨坏死出现相关的不同药物、根据疾病阶段使用的治疗方式以及记录的成功率，从初步检索中总共选择了29篇文章。
目前仍建议根据疾病阶段决定MRONJ的管理 - 在无症状的早期阶段首选保守治疗，而在有症状的骨暴露情况下首选手术管理。
