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Osteonecrosis of the jaw in the era of targeted therapy and immunotherapy in oncology

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Osteonecrosis of the jaw (ONJ) is a well-known pathological condition in oncology derived from the use of bisphosphonates (BPs) and denosumab. Many molecular and immunological targets have been introduced for daily use in cancer treatment in recent years; consequently, new cases of ONJ have been reported in association with these drugs, especially if administered with BPs and denosumab. When the drugs are administered alone, ONJ is rarely seen. The objective of our study was to analyze the recent literature relative to the association of ONJ with these new drugs highlighting the pathogenic, clinical and therapeutic aspects. The close collaboration between maxillofacial surgeon, oncologist, dentist, and dental hygienist remains the most important aspect for the prevention, prompt recognition, and treatment of this pathology.

I. Introduction

II. Tyrosine Kinase Inhibitors (TKIs)

III. Mammalian Target of Rapamycin Inhibitors (mTOR Inhibitors)

IV. Anti-angiogenics

V. Immunological Drugs

VI. MRONJ Prevention

VII. Conclusion

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