Akademik Veri Yönetim Sistemi
Cumhuriyet Dental Journal, cilt.28, sa.2, ss.278-286, 2025 (Scopus)
There is currently no specific evidence regarding the pathogenesis of MRONJ and no definitively accepted treatment. Inhibition of bone remodeling is thought to lead to reduced mechanical damage and the resulting accumulation of areas of bone necrosis. When used in therapeutic doses, bisphosphonates inhibit the resorptive activity of osteoclasts, while stimulating the differentiation and bone deposition of osteoblasts. As a result, the bone regeneration mechanism is impaired and the risk of avascular necrosis increases as a result of decreased bone remodeling. Bone resorption markers type I Collagen (Ctx) C-Terminal Telopeptide, Type I Collagen (NTX) N-Telopeptide, Tetrate Resistance Acid Phosphatase Isoform 5b (TRACP 5b), Nuclear Receptor Activator (RANKL) / Osteoprotegerin (OPG), Total Alkaline Phosphatase It has been reported that BRONJ is diagnosed by examining (Talp), Bone Specific Alkaline Phosphatase, Bone Sialoprotein, Pyridnoline, Deoxypyridnoline, Hydroxyproline values. CT is considered a standard method in the evaluation of MRONJ. Treatment of medication-induced osteonecrosis of the jaw basically aims to relieve pain, control secondary infection in soft and hard tissues, and minimize the progression of bone necrosis. Alternative treatment methods for MRONJ such as parathormone, platelet-rich plasma, laser applications, ozone treatment, use of bone morphogenic proteins, pentoxifylline, and surgical debridement guided by fluorescent staining method are also mentioned. The drugs that may be alternatıve to bıphosphonates are Denosumab, Strontıum Ranelate (Sr), Teriparatide, Edta, Stromal Vascular Fractıon Cells (Svf) but further studies are needed to be accepted as a definitive protocol. Despite the complications of bisphosphonate group drugs, their use is widespread and increasing due to their numerous indications. Informing dentists about the mechanism of bisphosphonate-derived drugs, denosumab and anti-angiogenic drugs the treatment of MRONJ and alternative drugs to these group drugs are important for the management of complications that develop due to these drugs.