Osteonecrosis of the jaw
Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
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| Osteonecrosis of the jaw | |
|---|---|
| Synonyms | ONJ, Dead jaw syndrome |
| Pronounce | N/A |
| Specialty | N/A |
| Symptoms | Pain, swelling, exposed bone in the mouth |
| Complications | Infection, fracture of the jaw |
| Onset | Typically after dental surgery or tooth extraction |
| Duration | Can be chronic |
| Types | N/A |
| Causes | Bisphosphonate use, Radiation therapy, Chemotherapy |
| Risks | Cancer, Osteoporosis, Periodontal disease |
| Diagnosis | Clinical examination, X-ray, CT scan |
| Differential diagnosis | Osteomyelitis, Periodontitis, Gingivitis |
| Prevention | Avoidance of invasive dental procedures during bisphosphonate therapy |
| Treatment | Antibiotics, Surgery, Hyperbaric oxygen therapy |
| Medication | N/A |
| Prognosis | Variable, can be difficult to treat |
| Frequency | Rare, more common in patients receiving high-dose bisphosphonates |
| Deaths | N/A |
Osteonecrosis of the Jaw (ONJ) is a severe bone disease that affects the jaws, including the maxilla and the mandible. It is characterized by the loss of blood supply to the bones, leading to bone death and eventual collapse of the affected area.
Causes
ONJ is often associated with the use of certain medications, particularly bisphosphonates and denosumab, which are used to treat osteoporosis and certain types of cancer. Other potential causes include radiation therapy to the head or neck, severe infection, or trauma to the jaw.
Symptoms
Symptoms of ONJ may include pain, swelling, or infection of the gums or jaw, loose teeth, and exposed bone. In severe cases, it can lead to difficulty eating or speaking, and may require surgical intervention.
Diagnosis
Diagnosis of ONJ is typically made through a combination of medical history, physical examination, and imaging studies such as X-rays or CT scans. A biopsy may also be performed to rule out other conditions.
Treatment
Treatment for ONJ focuses on eliminating the infection, preserving bone health, and managing symptoms. This may involve antibiotics, oral rinses, and pain management. In severe cases, surgical debridement or resection may be necessary.
Prevention
Prevention strategies for ONJ include good oral hygiene, regular dental check-ups, and avoiding invasive dental procedures when possible. Patients taking bisphosphonates or denosumab should discuss the risks and benefits with their healthcare provider.
See also
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Contributors: Prab R. Tumpati, MD