What Researchers Did
Researchers reviewed published studies on treatments for medication-related osteonecrosis of the jaw (MRONJ), a serious side effect of the jaw bone seen in some patients taking bone-strengthening or anti-angiogenic drugs.
What They Found
This systematic review searched Medline, Scopus, and Cochrane and selected 118 articles covering seven treatment categories: 75 on surgical interventions, 15 on platelet concentrates, 10 on laser therapy, 9 on conservative protocols, 4 on teriparatide, 3 on hyperbaric oxygen, and 2 on ozone applications. The evaluated articles reported positive improvements in healing or staging of the osteonecrosis sites after treatment. However, the authors state that because of the low evidence level and limited sample size of the included studies, these results must be cautiously interpreted. They describe the findings only as suggestive for evaluating the possible benefits of these treatment options, and say further prospective comparative studies with larger sample sizes are urgently needed to confirm them.
What This Means for Canadian Patients
For Canadian patients with MRONJ, this review indicates that several approaches, including hyperbaric oxygen, have been studied only in small numbers of low-quality studies (just 3 articles covered hyperbaric oxygen specifically). The authors do not conclude that any one option, including hyperbaric oxygen, is proven effective. Patients should discuss the uncertain and preliminary nature of this evidence with their treating dentist or oral surgeon.
Canadian Relevance
No direct Canadian connection identified.
Study Limitations
The authors themselves caution that the low evidence level and small sample sizes of the studies reviewed mean the results must be interpreted cautiously, and they call for larger, prospective comparative studies to confirm any benefit.