Osteoporos Sarcopenia.  2017 Jun;3(2):64-74. 10.1016/j.afos.2017.03.001.

Antiresorptive agent-related osteonecrosis of the jaw in osteoporosis patients from Asian countries

Affiliations
  • 1Department of Oral and Maxillofacial Radiology, School of Dentistry, Matsumoto Dental University, Shiojiri, Japan. akiro@po.mdu.ac.jp
  • 2Research Institute and Practice for Involutional Diseases, Nagano, Japan.
  • 3Citadel Oral and Facial Surgery, Halifax, NS, Canada.
  • 4Divisions of Endocrinology and Metabolism and Geriatrics, Department of Medicine, McMaster University, Hamilton, ON, Canada.

Abstract

Bisphosphonate (BP)-associated osteonecrosis of the jaw (ONJ) was first reported in oncology patients in 2003 and subsequently in osteoporosis patients in 2004. Since oral surgical procedures, such as tooth extraction, are also considered one of the major risk factors for ONJ, there is confusion among physicians, dentists, and patients"ā€¯particularly osteoporosis patients currently taking BPs"ā€¯regarding the safety of remaining on therapy surrounding these procedures. Many papers about BP-related ONJ (BRONJ) have been published to date. In addition to BRONJ, recent studies have reported an association between ONJ and the antiresorptive therapy denosumab (Dmab; a RANKL-inhibitor). BRONJ and Dmab-related ONJ are together referred to as antiresorptive agent-related ONJ (ARONJ). The pathogenesis of ARONJ still remains unknown. It is forecasted that there will be an increased incidence of patients with osteoporotic fractures and an increased number of prescriptions for antiresorptive agents in Asia in the future. However, prescriptions for antiresorptives for osteoporosis may be restricted in the Asian population as the occurrence of ARONJ may be higher as compared with those in other countries. In this review, we focused on the following topics as it pertains to the Asian osteoporotic population: the oral condition specific for osteoporosis patients; definition, staging, prevalence and incidence of ARONJ; imaging modalities for ARONJ; specific risk factors for ARONJ; prevention strategies for ARONJ, and; cooperation between physicians and dentists in the prevention of ARONJ. Ideally, the Asian Federation of Osteoporosis Societies would cooperate with one another and find more population-specific evidence for the prevention of ARONJ.

Keyword

Osteonecrosis; Jaw; Osteoporosis; Asia

MeSH Terms

Asia
Asian Continental Ancestry Group*
Bone Density Conservation Agents
Denosumab
Dentists
Humans
Incidence
Jaw*
Oral Surgical Procedures
Osteonecrosis*
Osteoporosis*
Osteoporotic Fractures
Prescriptions
Prevalence
Risk Factors
Tooth Extraction
Bone Density Conservation Agents
Denosumab
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