Osteonecrosi dei mascellari associata a bisfosfonati, denosumab e farmaci anti-angiogenetici nei pazienti oncologici e osteoporotici: prevenzione dentale e sicurezza dei trattamenti odontoiatrici

ONJ should be considered the most emerging disease that affects the oral cavity; ONJ is mainly due to bisphosphonates, but it has been also associated with denosumab and anti-angiogenic agents in recent years. Thousands of cases have been reported in the scientific literature so far, with important implications for the National Health Systems. ONJ can heavily impact on patients' quality of life. In all industrialized nations and in Italy too, guidelines or recommendations for the prevention and treatment of ONJ have been drafted. In the beginning, these documents were centred on the care of cancer patients taking intravenous bisphosphonates, but soon after they were upgraded to include the less-frequent ONJ in non-cancer patients taking bisphosphonates. To reduce the occurrence of ONJ in patients at risk, the role of the dentist is crucial in the effort to eliminate the known local risk factors applying specific dental treatment protocols, wherever indicated, and select the proper timing to deliver such treatments, both in cancer and non-cancer patients.