Chinese expert consensus on the diagnosis and clinical management of medication-related osteonecrosis of the jaw
Han-Jin Ruan, Chen Heng, Jinsong Hou, Jingang An, Yuxing Guo, Bing Liu, Lei Tian, Jian Pan, Jinsong Li, Canhua Jiang, Zhen Tian, Jie Xu, Ling Zhu, Changfu Sun, Ke-Qian Zhi, Qing Qu, Chunlin Zong, Mengyu Li, Zhiyuan Zhang, Yue He
Abstract
Medication-related osteonecrosis of the jaw (MRONJ) is a side effect that occurs after treatment for systemic diseases. However, most institutions currently rely on empirical methods to make diagnosis and treatment plans, and there is a lack of consensus or guidelines for the classification, staging and treatment of MRONJ in China. To address this gap and improve prognosis, an expert panel representing 11 renowned domestic medical colleges and affiliated hospitals in China was convened. The panel made a comprehensive literature review of previous treatment experiences and research findings to address issues of definitions, etiology and risk factors, diagnosis, treatment and prevention methods. The panel concluded that the diagnosis of MRONJ can be made on the basis of a history of related medications and typical clinical manifestations, with either typical radiographic manifestations or histopathological manifestations, after excluding jaw metastasis. Surgical treatment should be considered for symptomatic patients with sequestrum or bone abnormalities accompanied by recurrent infections, and He's classification was considered a practical clinical MRONJ staging system. Multidisciplinary comprehensive treatment should be proposed to achieve optimal treatment outcomes.