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INNOSC Theranostics and
Pharmacological Sciences Management and maintenance of oral health

Table 3. Information of articles included in this review
Studies Key outcomes/findings
AlRowis et al. [41] Careful dental preparation and instructions on oral hygiene significantly reduce the risk of ONJ.
Nicolatou- Oral clinicians play a critical role in the prevention of MRONJ as part of a multidisciplinary team.
Galitis et al. [27]
Drudge- Health-care professionals can play a key role alongside prescribers and oral clinicians in assessing the risk of MRONJ, thereby
Coates et al. [38] contributing to the prevention and management of the care pathway for these patients.
Fassio et al. [9] The majority of patients with MRONJ can be managed conservatively through optimal oral hygiene, regular professional dental care,
and elimination of active dental and periodontal disease.
Khan et al. [32] The development of ONJ can be mitigated by optimizing oral hygiene, and periodontal disease must be managed before starting
doses of antiresorptive drugs.
Migliario et al. [42] Primary prevention, carried out by dental hygienists, and secondary prevention, through professional oral hygiene and periodic
monitoring of the oral health status of patients at risk, are of fundamental importance to prevent the onset of lesions.
Campisi et al. [6] The diagnosis and prevention of MRONJ play a significant role not only in the quality of life of patients but also in the
decision-making process of the majority of doctors involved in the prevention of ONJ (primary and secondary).
Di Fede et al. [26] The application of primary and secondary prevention protocols by doctors and oral hygienists, in synergy with prescribers and
adequate patient awareness, is key to implementing strategies aimed at a common objective – the reduction of MRONJ outbreaks.
Abbreviations: MRONJ: Medication-related osteonecrosis of the jaw; ONJ: Osteonecrosis of the jaw.

Figure 2. A brochure outlining oral hygiene clinical protocols for patients undergoing antiresorptive drug treatment. The content of the brochure is
modified from references Giovanna Mosaico et al. , Drudge-Coates et al. , Migliario et al. , and National Cancer Institute .
[30]
[42]
[44]
[38]
finishing and polishing, especially in the lower jaw, are To encourage patient compliance and raise patients’
imperative, as the edges of these prosthetic artifacts must awareness of the importance of home oral hygiene, an
be rounded and beveled [54,55] . oral hygiene manual may be provided during the first visit
with oral health professionals. Furthermore, this same
At each follow-up visit, it is essential to reinforce the informational brochure could be disseminated in advance
motivation for maintaining oral health and controlling by the rheumatologist, orthopedist, and oncologist,
diabetes and MRONJ-related risk factors (Table 3) . aiming to promptly activate the MRONJ preventive
[56]

Volume 7 Issue 1 (2024) 4 https://doi.org/10.36922/itps.1419