Treatment of Osteonecrosis of the Jaw

Osteonecrosis of the jaw is a condition in which part of the lower jaw (mandible) or upper jaw (maxilla) loses its vitality and, as a result, the bone eventually dies.

This may cause symptoms such as pain, swelling, exposure of bone inside the mouth, difficulty chewing, and sometimes infections.

Main causes

There are different factors that can cause osteonecrosis of the jaw. The most common causes include:

  • Use of certain medications: Especially bisphosphonates and some cancer treatments, such as RANK-L inhibitors and other antiangiogenic agents. These medications may affect the bone’s ability to repair itself and remain healthy.
  • Tooth extractions or oral surgery: Invasive dental procedures can increase the risk, especially in people taking the medications mentioned above.
  • Radiation therapy to the maxillofacial area: Radiation can damage the bone’s blood vessels and compromise its vitality.
  • Severe periodontal disease: Chronic gum infections or inflammation can contribute to the development of osteonecrosis.

Available treatments

Treatment for osteonecrosis of the jaw depends on the stage or severity of the disease, as well as each patient’s specific conditions. The main goal is to control symptoms, prevent progression, and avoid complications.

  • Conservative measures: These include antiseptic mouth rinses, pain relievers, and antibiotics in case of infection. Maintaining good oral hygiene and avoiding trauma to the affected area are essential.
  • Debridement or surgical cleaning: In some cases, it is necessary to remove dead or infected tissue to promote bone healing.
  • Surgical closure of lesions: When there is bone exposure that does not respond to conservative treatment, procedures may be performed to cover the bone with healthy tissue.
  • Temporary discontinuation of medications (when possible): Under medical supervision, pausing the use of medications associated with osteonecrosis may be considered, as long as the benefits outweigh the risks.
  • Adjunctive therapies: Such as growth factors, hyperbaric oxygen therapy, or laser therapy may be considered in some cases to stimulate healing.

Recommendations for patients

  • Always inform your dentist and physician about the medications you take and any previous treatments you have received.
  • Maintain excellent oral hygiene and attend regular check-ups.
  • Avoid invasive dental procedures without first consulting your healthcare team.
  • If you experience pain, bone exposure, or any unusual symptoms in the mouth, consult a specialist immediately.

Osteonecrosis of the jaw is a treatable condition, especially when detected early and managed according to your medical team’s recommendations. Prevention and regular follow-up are essential to protect your oral and overall health.

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