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Differences between bisphosphonate-related and denosumab-related osteonecrosis of the jaws: a systematic review

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A Correction to this article was published on 18 March 2021

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Abstract

Objective

Bisphosphonates and denosumab are both antiresorptive medications, each with their own mechanism of action; yet both may result in the same adverse effect: medication-related osteonecrosis of the jaw (ONJ). The present systematic review aims to answer the following question: “Are bisphosphonate-related ONJ and denosumab-related ONJ any different, regarding clinical and imaging aspects?”

Methods

This review followed the Joanna Briggs Review’s Manual, and the searches were performed on PubMed, Cochrane, Scopus, Web of Science, and Lilacs databases and on the grey literature (ProQuest, Open Grey, and Google Scholar).

Results

The searches resulted in 7535 articles that were critically assessed. Based on the selection criteria, seven studies were included in the review: five cross-sectional studies and two randomized clinical trials. A total of 7755 patients composed the final population. An increase in bone sequestra, cortical bone lysis, and bone density was observed in bisphosphonate-related ONJ, while larger bone sequestra, more frequent periosteal reactions, and mandibular canal enhancement were noted in denosumab-related ONJ.

Conclusion

This systematic review demonstrated that the imaging characteristics of bisphosphonate-related and denosumab-related ONJ are not similar. Although clinically similar conditions, they were found to be radiographically distinct. More studies are necessary to further elucidate these differences.

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Acknowledgments

The authors would like to thank Margaret Durdan (University of Michigan) for proofreading this manuscript.

Funding

RQS was funded (by means of a scholarship) by CAPES—Coordination for the Improvement of Higher Education Personnel.

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Authors and Affiliations

  1. Health Sciences Faculty, University of Brasília, Brasilia, DF, 70910-900, Brazil

    Raiza Querrer, Nathália Ferrare, Nilce Melo, Cristine Miron Stefani, Paula Elaine Diniz dos Reis, Carla Ruffeil Moreira Mesquita, Gabriel Alvares Borges, André Ferreira Leite & Paulo Tadeu Figueiredo

  2. Interdisciplinary Research Laboratory Applied to Clinical Practice in Oncology, University of Brasília, Brasilia, DF, Brazil

    Paula Elaine Diniz dos Reis

  3. Laboratory of Oral Histopathology, Health Sciences Faculty, University of Brasilia, Brasilia, DF, Brazil

    Gabriel Alvares Borges

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  1. Raiza Querrer
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Contributions

• Idea for the article: NM, RQ, PTF, and AFL

• Literature search: RQ

• Data analysis: RQ, NF, and PTF

• Drafted the work: RQ, NM, GAB, PTF, and AFL

• Critically revised the work: RQ, NM, CRMM, CMS, PEDR, GAB, AFL, and PTF

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Correspondence to Raiza Querrer.

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Querrer, R., Ferrare, N., Melo, N. et al. Differences between bisphosphonate-related and denosumab-related osteonecrosis of the jaws: a systematic review. Support Care Cancer 29, 2811–2820 (2021). https://doi.org/10.1007/s00520-020-05855-6

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  • DOI: https://doi.org/10.1007/s00520-020-05855-6

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