ABSTRACT
Bone-modifying agents (BMAs) are integral to managing patients with advanced cancer. They improve quality of survival by reducing skeletal-related events, treating hypercalcaemia and chemotherapy-induced bone loss (Coleman in Clin Cancer Res 12: 6243s-6249s, 2006), (Coleman in Ann Oncol 31: 1650-1663, 2020). Two decades ago, medication-related osteonecrosis of the jaw (MRONJ) was first reported following BMA therapy (Marx in J Oral Maxillofac Surg 61: 1115-1117, 2003). The risk of MRONJ extends over a decade following BMA treatment with bisphosphonates, complicating dental care such as extractions. In addition, MRONJ has been reported following additional therapies such as antiangiogenic agents, cytotoxic agents, immunotherapy, and targeted agents. The use of BMAs in the curative and adjuvant cancer setting is increasing, consequently the implication of MRONJ is growing. Over the past 20 years, the literature has consolidated major risk factors for MRONJ, the pathophysiology and management strategies for MRONJ. Our review aims to document the development of MRONJ preventative and management strategies in cancer patients receiving a BMA. The authors advocate the incorporation of dental oncology strategies into contemporary cancer care, to optimise long-term quality of survival after cancer treatment.
Subject(s)
Bisphosphonate-Associated Osteonecrosis of the Jaw , Humans , Bisphosphonate-Associated Osteonecrosis of the Jaw/therapy , Bisphosphonate-Associated Osteonecrosis of the Jaw/etiology , Bone Density Conservation Agents/adverse effects , Bone Density Conservation Agents/therapeutic use , Neoplasms/drug therapy , Neoplasms/complications , Risk Factors , Antineoplastic Agents/adverse effects , Diphosphonates/adverse effects , Jaw Diseases/chemically induced , Jaw Diseases/therapyABSTRACT
AIMS AND OBJECTIVE: To determine the type, accuracy and content of information available on the Internet regarding the treatment of oral ulcers. METHOD: The search engine Google was used to generate a list of top 100 websites about 'mouth ulcer treatment'. The websites were evaluated using the DISCERN instrument and the JAMA benchmarks. Whether the site displayed the Health on the Net (HON) seal was also recorded. RESULTS: The search yielded 1,460,000 sites on the Google website. Of the top 100 sites a total of 54 sites were suitable for analysis due to duplicate links and non-functioning links. Of the websites analysed, 31.5% achieved all four JAMA benchmarks and 13% achieved only one benchmark. No website receiving the maximum mark on the overall score and six websites received the lowest overall score regarding the DISCERN instrument. The questions with the poorest response score were 'Does it describe how the treatment choices affect overall quality of life?' and 'Does it provide support for shared decision-making?'. Only 7.4% of the websites displayed the HON seal. CONCLUSION: Diverse information regarding the treatment of oral ulcers is available on the Internet with variable accuracy levels based on both JAMA benchmarks and DISCERN.