![]() Radiologic imaging is assumed to be a fundamental tool for diagnostic completion, defining the extent of the disease at the skeletal level, staging and the correct therapeutic planning. Radiologic Diagnosis of MRONJ: Practices at Risk of Inappropriateness and Good Practices The IAC-ONJ planned that a recommended practice equivalent will be advised for any inappropriate practice, within these 6 issues.Ģ.2. The experts focused on the topic of MRONJ using the following 6 main subcategories (issues): (1) clinical diagnosis (2) radiologic diagnosis (3) primary prevention (before and during drug intake) (4) dental management (5) drug holiday (temporary suspension vs. At the same time, the authors updated the easy applicable indications and procedures for dentists and oral surgeons, in order to reduce MRONJ onset risk and to diagnose it early. It is matter for the cancer (principally) and osteometabolic patients, since they are exposed to an increasing number of drugs with antiresorptive (i.e., bisphosphonates and denosumab) or antiangiogenic activities (e.g., bevacizumab aflibercept inhibitors of Tyrosine Kinases, TKIs and mTOR inhibitors). The updated Consensus Conference focused on the common practices still at risk of inappropriateness in MRONJ diagnosis and prevention, and on the dental management of patients exposed to ONJ. Some good practices were confirmed, while others were partially or fully updated (e.g., a drug holiday in osteometabolic patients, see Section 2.5) additionally, figures and tables have been added to some issues to emphasize some of the good practices. The present report was considered by the experts as convenient and worthwhile in the light of the new findings and the publication, in June 2020, of the new recommendations (2020) on MRONJ by SICMF/SIPMO, written on the inputs of the experts of the Italian Consensus group on ONJ (IAC-ONJ). The Conference was the first national consensus to address the MRONJ disease and specific interventions, it shared the definition of MRONJ as an “adverse drug reaction described as the progressive destruction and death of bone that affects the mandible and maxilla of patients exposed to the treatment with medications known to increase the risk of disease, in the absence of a previous radiation treatment”, to be diagnosed and scored by clinics and radiographs, independently from the presence of exposed necrotic bone or bone probing via sinus/fistula tracts for more than 8 weeks. The present report illustrates the update of conclusions adopted from the Consensus Conference held at the Symposium of the Italian Society of Oral Pathology and Medicine (SIPMO) on 20 October 2018, in Ancona (IT), when opinions were discussed and synthesized by 24 Italian experts. Medication-Related Osteonecrosis of Jaws (MRONJ) and its prevention play a role of great and rising importance, not only on the Quality of Life (QoL) of patients, but also on the decision-making process of the majority of dentists and oral surgeons, involved every day in MRONJ prevention (primary and secondary). Continuous updating on these issues, so important for the patient community, is recommended. At the same time, the Conference traced for dentists and oral surgeons some easy applicable indications and procedures to reduce MRONJ onset risk and to diagnose it early. It is a matter of cancer and osteometabolic patients that are at risk since being exposed to several drugs with antiresorptive (i.e., bisphosphonates and denosumab) or, more recently, antiangiogenic activities. The conference focused on the topic of MRONJ, and in particular on the common practices at risk of inappropriateness in MRONJ diagnosis and therapy, as well as on MRONJ prevention and the dental management of patients at risk of MRONJ. ![]() The present paper reports the update of the conclusions from the Consensus Conference-held at the Symposium of the Italian Society of Oral Pathology and Medicine (SIPMO) (20 October 2018, Ancona, Italy)-after the newest recommendations (2020) on MRONJ were published by two scientific societies (Italian Societies of Maxillofacial Surgery and Oral Pathology and Medicine, SICMF and SIPMO), written on the inputs of the experts of the Italian Allied Committee on ONJ (IAC-ONJ). The Medication-Related Osteonecrosis of Jaws (MRONJ) diagnosis process and its prevention play a role of great and rising importance, not only on the Quality of Life (QoL) of patients, but also on the decision-making process by the majority of dentists and oral surgeons involved in MRONJ prevention (primary and secondary). ![]()
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