Pre-operative protocol for patients undergoing surgery while using antirreabsorptive medications from FO UFF

Abstract

Medication-related osteonecrosis of the jaw (MRONJ) is considered a serious complication with a significant impact on dental practice. Among antiresorptive medications, we can mention the group of Bisphosphonates (BPs), the Anti-receptor Activator of NF-kappa B Ligand (Denosumab), and certain angiogenic inhibitor groups.
These medications have an important role in the treatment of various disorders affecting bone tissue, including osteoporosis, osteopenia, prevention of bone metastases from malignant neoplasms, as well as oncologic therapies. Therefore, the aim of this study was to develop a preoperative therapeutic protocol for patients using antiresorptive medication who are treated at FO-UFF. As a result, a protocol was created based on an extensive study of updated literature reviews, including approaches that should be recommended from the first consultation for effective and safe care, until pre- and post-surgery, with recommendations such as oral environment adequacy, mouthwash with 0.12% Chlorhexidine, and antibiotic prophylaxis. Ultimately, this resulted in a significant improvement in the assistance provided to patients undergoing oral surgical procedures and improved communication between university and students.

Keywords: Osteonecrosis, bisphosphonates, Denosumab, antiresorptive, antiangiogenics.