1. Adjuvant therapies in the management of medication‐related osteonecrosis of the jaws: Systematic review
- Author
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Felipe C Michellon, Tamara Fernandes de Castro, Ana Carolina Caio Passoni, Mariliani Chicarelli da Silva, Lilian Cristina Vessoni Iwaki, Lorena J A Ortega, and Elen de Souza Tolentino
- Subjects
Male ,medicine.medical_specialty ,medicine.medical_treatment ,Pain relief ,Pamidronate ,Decreased size ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Hyperbaric oxygen ,Laser therapy ,Randomized controlled trial ,law ,Internal medicine ,Humans ,Pain Management ,Medicine ,Aged ,Randomized Controlled Trials as Topic ,Aged, 80 and over ,Hyperbaric Oxygenation ,Bone Density Conservation Agents ,Diphosphonates ,Platelet-Rich Plasma ,business.industry ,Osteonecrosis ,030206 dentistry ,Middle Aged ,Combined Modality Therapy ,Systematic review ,Otorhinolaryngology ,030220 oncology & carcinogenesis ,Platelet-rich plasma ,Bisphosphonate-Associated Osteonecrosis of the Jaw ,Female ,Laser Therapy ,Denosumab ,business ,Adjuvant ,Jaw Diseases - Abstract
Background We investigated the efficacy of hyperbaric oxygen (HBO), low-intensity laser (LIL), and platelet-rich plasma (PRP) in the management of medication-related osteonecrosis of the jaws (MRONJ). Methods A literature search was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Two examiners independently assessed eligibility and risk of bias and extracted data. Results There was improvement in 75.6% of the 41 patients submitted to HBO, with positive effects on pain relief and decreased size and number of lesions at a faster rate, with better effects when the drug was discontinued. For LIL, 158 (64.2%) of the 246 patients/sites improved the symptoms and 98 (39.8%) healed completely. Fourteen (17.3%) of the 81 patients treated with PRP significantly improved the symptoms and 65 (80.2%) completely healed. Conclusions These therapies served as safe and effective adjuvant modalities for MRONJ treatment. The lack of randomized clinical trials evidences the need for more high-quality investigations on the subject.
- Published
- 2019
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