American Association of Oral and Maxillofacial Surgeons position paper on medication-related osteonecrosis of the jaw:​ 2014 update

Ruggiero, Salvatore L.; Dodson, Thomas B.; Fantasia, John; Goodday, Reginald; Aghaloo, Tara; Mehrotra, Bhoomi; O'Ryan, Felice

Affiliations

¹Clinical Professor, Division of Oral and Maxillofacial Surgery, Stony Brook School of Dental Medicine, Hofstra North Shore-LIJ School of Medicine, New York Center for Orthognathic and Maxillofacial Surgery, Lake Success, NY

²Professor and Chair, Associate Dean for Hospital Affairs, Department of Oral and Maxillofacial Surgery, University of Washington School of Dentistry, Seattle, WA

³Chief, Division of Oral Pathology, Department of Dental Medicine, Hofstra North Shore-LIJ School of Medicine, New Hyde Park, NY

⁴Professor, Department of Oral and Maxillofacial Sciences, Dalhousie University, Halifax, NS, Canada

⁵Associate Professor, Oral and Maxillofacial Surgery, Assistant Dean for Clinical Research, UCLA School of Dentistry, Los Angeles, CA

⁶Director, Cancer Institute at St Francis Hospital, Roslyn, NY

⁷Director, Division of Maxillofacial Surgery, Kaiser Permanente Oakland Medical Center, Oakland, CA

Abstract

Strategies for management of patients with, or at risk for, medication-related osteonecrosis of the jaw (MRONJ) were set forth in the American Association of Oral and Maxillofacial Surgeons (AAOMS) position papers in 2007 and 2009. The position papers were developed by a special committee appointed by the board and composed of clinicians with extensive experience in caring for these patients and basic science researchers. The knowledge base and experience in addressing MRONJ has expanded, necessitating mod- ifications and refinements to the previous position paper. This special committee met in September 2013 to appraise the current literature and revise the guidelines as indicated to reflect current knowledge in this field. This update contains revisions to diagnosis, staging, and management strategies and highlights current research status. The AAOMS considers it vitally important that this information be disseminated to other relevant health care professionals and organizations.

Links

DOI: 10.1016/j.joms.2014.04.031

PubMed: 25234529

WoS: 000342466500013

History

Received: 2014-04-11

Revised: 2014-04-21

Accepted: 2014-04-21

Online: 2014-05-5

Cited Works (8)

Year	Entry
2012	Papapoulos S, Chapurlat R, Libanati C, Brandi ML, Brown JP, Czerwiński E, Krieg M-A, Man Z, Mellström D, Radominski SC, Reginster J-Y, Resch H, Ivorra JAR, Roux C, Vittinghoff E, Austin M, Daizadeh N, Bradley MN, Grauer A, Cummings SR, Bone HG. Five years of denosumab exposure in women with postmenopausal osteoporosis: results from the first two years of the FREEDOM extension. J Bone Miner Res. March 2012;27(3):694-701.
2003	Marx RE. Pamidronate (Aredia) and zoledronate (Zometa) induced avascular necrosis of the jaws: a growing epidemic. J Oral Maxillofac Surg. September 2003;61(9):1115-1117.
2008	Russell RGG, Watts NB, Ebetino FH, Rogers MJ. Mechanisms of action of bisphosphonates: similarities and differences and their potential influence on clinical efficacy. Osteoporos Int. June 2008;19(6):733-759.
2011	Baron R, Ferrari S, Russell RGG. Denosumab and bisphosphonates: different mechanisms of action and effects. Bone. April 2011;48(4):677-692.
2009	Cummings SR, San Martin J, McClung MR, Siris ES, Eastell R, Reid IR, Delmas P, Zoog HB, Austin M, Wang A, Kutilek S, Adami S, Zanchetta J, Libanati C, Siddhanti S, Christiansen C; FREEDOM Trial. Denosumab for prevention of fractures in postmenopausal women with osteoporosis. NEJM. August 20, 2009;361(8):756-765.
2012	Black DM, Reid IR, Boonen S, Bucci-Rechtweg C, Cauley JA, Cosman F, Cummings SR, Hue TF, Lippuner K, Lakatos P, Leung PC, Man Z, Martinez RLM, Tan M, Ruzycky ME, Su G, Eastell R. The effect of 3 versus 6 years of Zoledronic acid treatment of osteoporosis: a randomized extension to the HORIZON-Pivotal Fracture Trial (PFT). J Bone Miner Res. February 2012;27(2):243-254.
2004	Ruggiero SL, Mehrotra B, Rosenberg TJ, Engroff SL. Osteonecrosis of the jaws associated with the use of bisphosphonates: a review of 63 cases. J Oral Maxillofac Surg. May 2004;62(5):527-534.
1996	Lin JH. Bisphosphonates: a review of their pharmacokinetic properties. Bone. February 1996;18(2):75-85.

Cited By (31)

Year	Entry
2020	Messer JG, Castillo EJ, Abraham AM, Jiron JM, Israel R, Yarrow JF, Thomas S, Reynolds MC, Wnek RD, Jorgensen M, Wanionok N, Van Poznak C, Bhattacharyya I, Kimmel DB, Aguirre JI. Anti-vascular endothelial growth factor antibody monotherapy causes destructive advanced periodontitis in rice rats (Oryzomys palustris). Bone. January 2020;130:115141.
2020	Ferrari S, Lewiecki EM, Butler PW, Kendler DL, Napoli N, Huang S, Crittenden DB, Pannacciulli N, Siris E, Binkley N. Favorable skeletal benefit/risk of long-term denosumab therapy: a virtual-twin analysis of fractures prevented relative to skeletal safety events observed. Bone. May 2020;134:115287.
2020	Hayano H, Kuroshima S, Sasaki M, Tamaki S, Inoue M, Ishisaki A, Sawase T. Distinct immunopathology in the early stages between different antiresorptives-related osteonecrosis of the jaw-like lesions in mice. Bone. June 2020;135:115308.
2020	Lesclous P, Cloitre A, Catros S, Devoize L, Louvet B, Châtel C, Foissac F, Roux C. Alendronate or zoledronic acid do not impair wound healing after tooth extraction in postmenopausal women with osteoporosis. Bone. August 2020;137:115412.
2020	Pfeilschifter J, Steinebach I, Trampisch HJ, Rudolf H. Bisphosphonate drug holidays: risk of fractures and mortality in a prospective cohort study. Bone. September 2020;138:115431.
2020	Govaerts D, Piccart F, Ockerman A, Coropciuc R, Politis C, Jacobs R. Adjuvant therapies for MRONJ: a systematic review. Bone. December 2020;141:115676.
2020	Tamaki S, Kuroshima S, Hayano H, Nakajima K, Kakehashi H, Ishisaki A, Sawase T. Dynamic polarization shifting from M1 to M2 macrophages in reduced osteonecrosis of the jaw-like lesions by cessation of anti-RANKL antibody in mice. Bone. December 2020;141:115560.
2021	Castillo EJ, Messer JG, Abraham AM, Jiron JM, Alekseyenko AV, Israel R, Thomas S, Gonzalez-Perez GM, Croft S, Gohel A, Bhattacharyya I, Yarrow JF, Novince CM, Kimmel DB, Aguirre JI. Preventing or controlling periodontitis reduces the occurrence of osteonecrosis of the jaw (ONJ) in rice rats (Oryzomys palustris). Bone. April 2021;145:115866.
2021	Sedghizadeh PP, Sun S, Jones AC, Sodagar E, Cherian P, Chen C, Junka AF, Neighbors JD, McKenna CE, Russell RGG, Ebetino FH. Bisphosphonates in dentistry: historical perspectives, adverse effects, and novel applications. Bone. June 2021;147:115933.
2021	D'Oronzo S, Wood S, Brown JE. "The use of bisphosphonates to treat skeletal complications in solid tumours". Bone. June 2021;147:115907.
2021	Inoue M, Matsumoto C, Nakajima K, Kuroshima S, Sawase T. Alendronate/dexamethasone combination therapy worsens soft and hard tissue wound healing around implants in rat maxillae. Bone. July 2021;148:115942.
2021	Soundia A, Hadaya D, Chau Y, Gkouveris I, Bezouglaia O, Dry S, Pirih F, Aghaloo T, Tetradis S. Local RANKL delivery improves socket healing in bisphosphonate treated rats. Bone. July 2021;148:115945.
2022	Jara MA, Varghese J, Hu MI. Adverse events associated with bone-directed therapies in patients with cancer. Bone. May 2022;158:115901.
2022	de Sousa VC, Sousa FRN, Vasconcelos RF, Martins CS, Lopes AP, Alves NM, Viana D, Alves K, Leitão R, Brito GAC, Girão V, Goes P. Atorvastatin reduces zoledronic acid-induced osteonecrosis of the jaws of rats. Bone. November 2022;164:116523.
2020	Camacho PM, Petak SM, Binkley N, Diab DL, Eldeiry LS, Farooki A, Harris ST, Hurley DL, Kelly J, Lewiecki EM, Pessah-Pollack R, McClung M, Wimalawansa SJ, Watts NB. American Association of Clinical Endocrinologists/American College of Endocrinology Clinical practice guidelines for the diagnosis and treatment of postmenopausal osteoporosis: 2020 update. Endocr Pract. May 2020;26(suppl 1):1-46.
2015	Khan AA, Morrison A, Hanley DA, Felsenberg D, McCauley LK, O'Ryan F, Reid IR, Ruggiero SL, Taguchi A, Tetradis S, Watts NB, Brandi ML, Peters E, Guise T, Eastell R, Cheung AM, Morin SN, Masri B, Cooper C, Morgan SL, Obermayer-Pietsch B, Langdahl BL, Al Dabagh R, Davison KS, Kendler DL, Sándor GK, Josse RG, Bhandari M, El Rabbany M, Pierroz DD, Sulimani R, Saunders DP, Brown JP, Compston J; International Task Force on Osteonecrosis of the Jaw. Diagnosis and management of osteonecrosis of the jaw: a systematic review and international consensus. J Bone Miner Res. January 2015;30(1):3-23.
2019	Hadaya D, Gkouveris I, Soundia A, Bezouglaia O, Boyce RW, Stolina M, Dwyer D, Dry SM, Pirih FQ, Aghaloo TL, Tetradis S. Clinically relevant doses of sclerostin antibody do not induce osteonecrosis of the jaw (ONJ) in rats with experimental periodontitis. J Bone Miner Res. January 2019;34(1):171-181.
2020	Conley RB, Adib G, Adler RA, Åkesson KE, Alexander IM, Amenta KC, Blank RD, Brox WT, Carmody EE, Chapman‐Novakofski K, Clarke BL, Cody KM, Cooper C, Crandall CJ, Dirschl DR, Eagen TJ, Elderkin AL, Fujita M, Greenspan SL, Halbout P, Hochberg MC, Javaid M, Jeray KJ, Kearns AE, King T, Koinis TF, Koontz JS, Kužma M, Lindsey C, Lorentzon M, Lyritis GP, Michaud LB, Miciano A, Morin SN, Mujahid N, Napoli N, Olenginski TP, Puzas JE, Rizou S, Rosen CJ, Saag K, Thompson E, Tosi LL, Tracer H, Khosla S, Kiel DP. Secondary fracture prevention: consensus clinical recommendations from a multistakeholder coalition. J Bone Miner Res. January 2020;35(1):36-52.
2020	Nordström P, Bergman J, Ballin M, Björk S, Nordström A. Bone‐specific drugs and osteonecrosis of sites other than the jaw: a nationwide cohort study. J Bone Miner Res. September 2020;35(9):1703-1710.
2020	Otto S, Pautke C, Arens D, Poxleitner P, Eberli U, Nehrbass D, Zeiter S, Stoddart MJ. A drug holiday reduces the frequency and severity of medication‐related osteonecrosis of the jaw in a minipig model. J Bone Miner Res. November 2020;35(11):2179-2192.
2021	Yang G, Collins JM, Rafiee R, Singh S, Langaee T, McDonough CW, Holliday LS, Wang D, Lamba JK, Kim YS, Pelliccioni GA, Vaszilko M, Kosa JP, Balla B, Lakatos PA, Katz J, Moreb J, Gong Y. SIRT1 gene SNP rs932658 is associated with medication‐related osteonecrosis of the jaw. J Bone Miner Res. February 2021;36(2):347-356.
2022	Everts-Graber J, Lehmann D, Burkard J-P, Schaller B, Gahl B, Häuselmann H, Studer U, Ziswiler H-R, Reichenbach S, Lehmann T. Risk of osteonecrosis of the jaw under denosumab compared to bisphosphonates in patients with osteoporosis. J Bone Miner Res. February 2022;37(2):340-348.
2022	Gkouveris I, Hadaya D, Elzakra N, Soundia A, Bezouglaia O, Dry SM, Pirih F, Aghaloo T, Tetradis S. Inhibition of HMGB1/RAGE signaling reduces the incidence of medication-related osteonecrosis of the jaw (MRONJ) in mice. J Bone Miner Res. September 2022;37(9):1775-1786.
2022	Yang G, Williams R, Wang L, Farhadfar N, Chen Y, Loiacono AT, Bian J, Holliday LS, Katz J, Gong Y. Medication-related osteonecrosis of the jaw in cancer patients: result from the OneFlorida Clinical Research Consortium. J Bone Miner Res. December 2022;37(12):2466-2471.
2020	Chiu W-Y, Lin C-J, Yang W-S, Tsai K-S, Reginster J-Y. Racial difference in bioavailability of oral ibandronate between Caucasian and Taiwanese postmenopausal women. Osteoporos Int. January 2020;31(1):193-201.
2020	Ohbayashi Y, Iwasaki A, Nakai F, Mashiba T, Miyake M. A comparative effectiveness pilot study of teriparatide for medication-related osteonecrosis of the jaw: daily versus weekly administration. Osteoporos Int. March 2020;31(3):577-585.
2020	Kim JY, Choi H, Park JH, Jung HD, Jung YS. Effects of anti-resorptive drugs on implant survival and peri-implantitis in patients with existing osseointegrated dental implants: a retrospective cohort study. Osteoporos Int. September 2020;31(9):1749-1758.
2020	Gomes-Ferreira PHS, de Oliveira D, Frigério PB, de Souza Batista FR, Grandfield K, Okamoto R. Teriparatide improves microarchitectural characteristics of peri-implant bone in orchiectomized rats. Osteoporos Int. September 2020;31(9):1807-1815.
2017	Mathavan N. The Anabolic - Anti-Catabolic Paradigm of Augmenting Skeletal Regeneration: A Bone Quality Perspective [PhD thesis]. Lund, Sweden: Lund University; 2017.
2019	George EL. Quantifying the Roles of Stimulated Osteocytes and Inflammation in Bone Remodeling [PhD thesis]. Akron, OH: University of Akron; May 2019.
2020	Hadaya D. Osteonecrosis of the Jaws: Investigations Into Pathophysiology and Prevention [PhD thesis]. Los Angeles (UCLA), University of California; 2020.