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Osteonecrosis of the Jaw in Association with Targeted Therapy

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Medication-Related Osteonecrosis of the Jaws

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Abstract

Various non-bisphosphonate drugs seem to be associated with the etiology of osteonecrosis of the jaw (ONJ). The human monoclonal antibodies denosumab and bevacizumab and the tyrosine kinase inhibitor sunitinib have been suspected to increase the risk for ONJ development. Very recent reports have identified the mTOR (mammalian target of rapamycin) inhibitor everolimus to be implicated in the evolution of ONJ. Current evidence supports the theory that denosumab treatment in isolation may trigger ONJ. Bevacizumab and sunitinib as part of oncologic treatment protocols which include bisphosphonates may increase the likelihood for ONJ and reduce the latency period until ONJ occurrence. Dentoalveolar surgeries in patients on these drugs should be performed with the same precautions as for bisphosphonate patients.

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Authors and Affiliations

  1. Department of Oral and Maxillofacial Surgery, Ludwig – Maximilians Universität München, München, Germany

    Matthias Troeltzsch MD, DMD & Christoph Pache MD, DMD

  2. Department of Maxillofacial Surgery, Universitätsmedizin Göttingen, Göttingen, Germany

    Markus Troeltzsch MD, DMD

  3. Department of Hematology and Oncology, School of Medicine and Dentistry, University of Rochester, Rochester, NY, USA

    Timothy Woodlock MD

  4. Unity Health System, Rochester, NY, USA

    Timothy Woodlock MD

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  1. Matthias Troeltzsch MD, DMD
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  2. Markus Troeltzsch MD, DMD
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  3. Christoph Pache MD, DMD
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  4. Timothy Woodlock MD
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Correspondence to Matthias Troeltzsch MD, DMD .

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  1. Department of Oral and Maxillofacial Sur, Ludwig-Maximilians-University of Munich, Munich, Germany

    Sven Otto

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Troeltzsch, M., Troeltzsch, M., Pache, C., Woodlock, T. (2015). Osteonecrosis of the Jaw in Association with Targeted Therapy. In: Otto, S. (eds) Medication-Related Osteonecrosis of the Jaws. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-43733-9_18

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  • DOI: https://doi.org/10.1007/978-3-662-43733-9_18

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