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Objective: Medication-related osteonecrosis of the jaw (MRONJ) is a severe adverse reaction caused by the use of antiresorptive antiangiogenic medication. Treating MRONJ is difficult and besides standard treatments, which are conservative medical and surgical approaches, there are some adjuvant therapies that might further stimulate healing. The aim of this systematic review is to compare outcome and effectiveness of currently available adjuvant therapies for MRONJ.

Methods: This systematic review was conducted following the PRISMA guidelines. Articles focusing on mucosal healing in patients treated with an adjuvant therapy for MRONJ were selected and analysed. Inclusion was not limited to randomized controlled trials to present a complete review of the current literature.

Results: A search was performed in Pubmed, Embase, Web of Science and Cochrane Central Register of Controlled Trials. Thirty articles out of 3297 were included. Laser ablation had a success of 60-95% for complete healing. The controlled trials of leukocyte- and platelet-rich-fibrine (LPRF) showed 60-100% success for the same outcome. Fluorescence guided surgery had a complete healing percentage of 85-90%.

Conclusions: The results suggest that laser ablation, LPRF and fluorescence guided surgery might have a potential in improving the healing process. Interpreting the results should however be done with great care and a critical point of view, as most articles had a medium to high risk of bias. More randomized controlled trials are necessary to define the most beneficial therapy protocols.

Clinical Relevance: It seems that adjuvant surgical therapies for treating MRONJ are beneficial for mucosal healing, but there is only low scientific evidence.

Titel:	Adjuvant therapies for MRONJ: A systematic review.
Autor/in / Beteiligte Person:	Govaerts, D ; Piccart, F ; Ockerman, A ; Coropciuc, R ; Politis, C ; Jacobs, R
Zeitschrift:	Bone, Jg. 141 (2020-12-01), S. 115676
Veröffentlichung:	New York : Elsevier Science ; <i>Original Publication</i>: Elmsford, NY : Pergamon Press, c1985-, 2020
Medientyp:	academicJournal
ISSN:	1873-2763 (electronic)
DOI:	10.1016/j.bone.2020.115676
Schlagwort:	Humans Bisphosphonate-Associated Osteonecrosis of the Jaw Bone Density Conservation Agents
Sonstiges:	Nachgewiesen in: MEDLINE Sprachen: English Publication Type: Journal Article; Review; Systematic Review Language: English [Bone] 2020 Dec; Vol. 141, pp. 115676. <i>Date of Electronic Publication: </i>2020 Oct 03. MeSH Terms: Bisphosphonate-Associated Osteonecrosis of the Jaw* ; Bone Density Conservation Agents* ; Humans Contributed Indexing: Keywords: Bisphosphonates; Denosumab; LPRF; Medication-related osteonecrosis of the jaw; Osteonecrosis; Therapy; laser ablation Substance Nomenclature: 0 (Bone Density Conservation Agents) Entry Date(s): Date Created: 20201006 Date Completed: 20210617 Latest Revision: 20210617 Update Code: 20240513

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Adjuvant therapies for MRONJ: A systematic review.