Abstract
Medication-related osteonecrosis of the jaw (MRONJ) is a known complication of antiresorptive and anti-angiogenic therapies in adults. Increasingly, these drugs are being prescribed for children with a variety of conditions, such as osteogenesis imperfecta and cancers of the bone. Review of the literature, however, reveals no reported paediatric MRONJ cases to date. We present such a case in a nine-year-old female patient with a vertebral aneurysmal bone cyst, who received dental extractions subsequent to denosumab therapy.
Key points
Increase awareness of the existence of paediatric medication-related osteonecrosis of the jaw.
Highlight the possible impact of dental treatment on children on antiresorptive medication.
Encourage further reporting of cases for future review.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 24 print issues and online access
$259.00 per year
only $10.79 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
Similar content being viewed by others
References
Marx R E. Pamidronate (Aredia) and zoledronate (Zometa) induced avascular necrosis of the jaws: a growing epidemic. J Oral Maxillofac Surg 2003; 61: 1115-1117.
Bhatt R, Hibbert S A, Munns C F. The use of bisphosphonates in children: review of the literature and guidelines for dental management. Aust Dent J 2014; 59: 9-19.
Duarte N T, Rech B O, Martins I G, Franco J B, Ortega K L. Can children be affected by bisphosphonate-related osteonecrosis of the jaw? A systematic review. Int J Oral Maxillofac Surg 2020; 49: 183-191.
Ruggiero S L, Dodson T B, Fantasia J et al. American Association of Oral and Maxillofacial Surgeons position paper on medication-related osteonecrosis of the jaw - 2014 update. J Oral Maxillofac Surg 2014; 72: 1938-1956.
Hanley D A, Adachi J D, Bell A, Brown V. Denosumab: mechanism of action and clinical outcomes. Int J Clin Pract 2012; 66: 1139-1146.
Christou J, Johnson A R, Hodgson T A. Bisphosphonate-related osteonecrosis of the jaws and its relevance to children - a review. Int J Paediatr Dent 2013; 23: 330-337.
Fangusaro J, Gururangan S, Jakacki R I et al. Bevacizumab-associated osteonecrosis of the wrist and knee in three paediatric patients with recurrent CNS tumours. J Clin Oncol 2013; 31: 24-27.
Scottish Dental Clinical Effectiveness Programme. Oral Health Management of Patients at Risk of Medication-Related Osteonecrosis of the Jaw. 2017. Available at https://www.sdcep.org.uk/media/m0ko0gng/sdcep-oral-health-management-of-patients-at-risk-of-mronj-guidance-full.pdf (accessed July 2020).
De Molon R S, Hsu C, Bezouglaia O et al. Rheumatoid Arthritis Exacerbates the Severity of Osteonecrosis of the Jaws (ONJ) in Mice. A Randomized, Prospective, Controlled Animal Study. J Bone Miner Res 2016; 31: 1596-1607.
Kuroshima S, Nakajima K, Sasaki M et al. Systemic administration of quality- and quantity-controlled PBMNCs reduces bisphosphonate-related osteonecrosis of jaw-like lesions in mice. Stem Cell Res Ther 2019; 10: 209.
Kamoun-Goldrat A, Ginisty D, Le Merrer M. Effects of bisphosphonates on tooth eruption in children with osteogenesis imperfecta. Eur J Oral Sci 2008; 116: 195-198.
De Souza Tolentino E, de Castro T F, Michellon F C et al. Adjuvant therapies in the management of medication-related osteonecrosis of the jaws: Systematic review. Head Neck 2019; 41: 4209-4228.
Author information
Authors and Affiliations
Contributions
Dominic Innes-Taylor - designer and writer of the article. Vicky Adams - reviewer and editor.
Corresponding author
Ethics declarations
The authors declare no conflicts of interest.
Written consent to publish was obtained for the publication of this case.
Rights and permissions
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Innes-Taylor, D., Adams, V. Medication-related osteonecrosis of the jaw in a paediatric patient taking denosumab: a case report. Br Dent J 236, 453–456 (2024). https://doi.org/10.1038/s41415-024-7139-8
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/s41415-024-7139-8