Antiresorptive Therapie – Risiko, Therapie und Prophylaxe von Kieferknochennekrosen

Bisphosphonate und Denosumab dominieren die Prophylaxe skelettaler Ereignisse, maligner Erkrankungen und der Osteoporose. Die Bisphosphonat-assoziierte Kiefernekrose (BRONJ) wurde erstmals 2003, die Kiefernekrose bei Denosumab 2010 beschrieben. 2011 wurde die Bezeichnung ARONJ (antiresorptive Medikamente-assoziierte Kiefernekrose) vorgeschlagen. Die Literaturangaben zur Ätiopathologie und Therapie von ARONJ sind widersprüchlich. Der Artikel gibt, entsprechend der aktuellen Studienanlage, eine Synopsis der ARONJ und referiert die leitlinienbasierten Empfehlungen zu Prophylaxe und Behandlung.

• Literatur

• 1 Nancollas GH, Tang R, Phipps RJ et al. Novel insights into actions of bisphosphonates on bone: differences in interactions with hydroxyapatite. Bone 2006; 38: 617-627
• 2 Coleman RE. The clinical use of bone resorption markers in patients with malignant bone disease. Cancer 2002; 94: 2521-2533
• 3 Cummings SR, San Martin J, McClung MR et al. Denosumab for prevention of fractures in postmenopausal women with osteoporosis. New Engl J Med 2009; 361: 756-765
• 4 Ristow O, Gerngross C, Schwaiger M et al. Effect of antiresorptive drugs on bony turnover in the jaw: denosumab compared with bisphosphonates. Br J Oral Maxillofac Surg 2014; 52: 308-313
• 5 Koerdt S, Dax S, Grimaldi H et al. Histomorphologic characteristics of bisphosphonate-related osteonecrosis of the jaw. J Oral Pathol Med 2014; 43: 448-453
• 6 Marx RE, Sawatari Y, Fortin M et al. Bisphosphonate-induced exposed bone (osteonecrosis/osteopetrosis) of the jaws: risk factors, recognition, prevention, and treatment. J Oral Maxillofac Surg 2005; 63: 1567-1575
• 7 Misso G, Porru M, Stoppacciaro A et al. Evaluation of the in vitro and in vivo antiangiogenic effects of denosumab and zoledronic acid. Cancer biology & therapy 2012; 13: 1491-1500
• 8 Ruggiero SL. Bisphosphonate-related osteonecrosis of the jaw (BRONJ): initial discovery and subsequent development. J Oral Maxillofac Surg 2009; 67 (Suppl) 13-18
• 9 Hellstein JW, Adler RA, Edwards B et al. Managing the care of patients receiving antiresorptive therapy for prevention and treatment of osteoporosis: executive summary of recommendations from the American Dental Association Council on Scientific Affairs. J Am Dent Assoc 2011; 142: 1243-1251
• 10 Patel S, Choyee S, Uyanne J et al. Non-exposed bisphosphonate-related osteonecrosis of the jaw: a critical assessment of current definition, staging, and treatment guidelines. Oral diseases 2012; 18: 625-632
• 11 Colella G, Campisi G, Fusco V. American Association of Oral and Maxillofacial Surgeons position paper: Bisphosphonate-Related Osteonecrosis of the Jaws-2009 update: the need to refine the BRONJ definition. J Oral Maxillofac Surg 2009; 67: 2698-2699
• 12 Lo JC, O’Ryan FS, Gordon NP et al. Prevalence of osteonecrosis of the jaw in patients with oral bisphosphonate exposure. J Oral Maxillofac Surg 2010; 68: 243-253
• 13 Sigua-Rodriguez EA, da Costa Ribeiro R, de Brito AC et al. Bisphosphonate-related osteonecrosis of the jaw: a review of the literature. Int J Dent 2014; 2014: 192320
• 14 Hines SL, Mincey B, Dentchev T et al. Immediate versus delayed zoledronic acid for prevention of bone loss in postmenopausal women with breast cancer starting letrozole after tamoxifen-N03CC. Breast Cancer Res Treat 2009; 117: 603-609
• 15 Vahtsevanos K, Kyrgidis A, Verrou E et al. Longitudinal cohort study of risk factors in cancer patients of bisphosphonate-related osteonecrosis of the jaw. J Clin Oncol 2009; 27: 5356-5362
• 16 Guarneri V, Miles D, Robert N et al. Bevacizumab and osteonecrosis of the jaw: incidence and association with bisphosphonate therapy in three large prospective trials in advanced breast cancer. Breast Cancer Res Treat 2010; 122: 181-188
• 17 al GKe. Bisphosphonat-assoziierte Kiefernekrose (BP-ONJ) und andere Medikamenten-assoziierte Kiefernekrosen. AWMF-Register Nr 007/091, S3-Leitlinie 2012
• 18 Haidar A, Jonler M, Folkmar TB et al. Bisphosphonate (zoledronic acid)-induced osteonecrosis of the jaw. Scand J Urol Nephrol 2009; 43: 442-444
• 19 Montefusco V, Gay F, Spina F et al. Antibiotic prophylaxis before dental procedures may reduce the incidence of osteonecrosis of the jaw in patients with multiple myeloma treated with bisphosphonates. Leukemia & lymphoma 2008; 49: 2156-2162
• 20 Mozzati M, Arata V, Gallesio G. Tooth extraction in osteoporotic patients taking oral bisphosphonates. Osteoporos Int 2013; 24: 1707-1712
• 21 Otto S, Baumann S, Ehrenfeld M et al. Successful surgical management of osteonecrosis of the jaw due to RANK-ligand inhibitor treatment using fluorescence guided bone resection. J Craniomaxillofac Surg 2013; 41: 694-698
• 22 Russell MA, Laws AP, Atherton JH et al. The mechanism of the phosphoramidite synthesis of polynucleotides. Organic & biomolecular chemistry 2008; 6: 3270-3275
• 23 Schwartz HC. American Association of Oral and Maxillofacial Surgeons Position Paper on Medication-Related Osteonecrosis of the Jaw-2014 Update and CTX. J Oral Maxillofac Surg 2015; 73: 377
• 24 Stockmann P, Vairaktaris E, Wehrhan F et al. Osteotomy and primary wound closure in bisphosphonate-associated osteonecrosis of the jaw: a prospective clinical study with 12 months follow-up. Support Care Cancer 2010; 18: 449-460
• 25 Ruggiero SL, Mehrotra B, Rosenberg TJ et al. Osteonecrosis of the jaws associated with the use of bisphosphonates: a review of 63 cases. J Oral Maxillofac Surg 2004; 62: 527-534
• 26 Montebugnoli L, Felicetti L, Gissi DB et al. Biphosphonate-associated osteonecrosis can be controlled by nonsurgical management. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2007; 104: 473-477
• 27 Graziani F, Vescovi P, Campisi G et al. Resective surgical approach shows a high performance in the management of advanced cases of bisphosphonate-related osteonecrosis of the jaws: a retrospective survey of 347 cases. J Oral Maxillofac Surg 2012; 70: 2501-2507
• 28 Ristow O, Otto S, Troeltzsch M et al. Treatment perspectives for medication-related osteonecrosis of the jaw (MRONJ). J Craniomaxillofac Surg 2015; 43: 290-293