The term ‘Osteonecrosis of the jaw (ONJ)’ encompasses rare complications affecting the jawbone, following exposure to radiation therapy (osteoradionecrosis, ORN) or medications such as anti-resorptive, anti-angiogenic medications, etc., collectively termed medication-related ONJ (MRONJ). Both entities present a significant diagnostic and therapeutic challenge in oral and maxillofacial surgery.
The recent update from the American Association of Oral and Maxillofacial Surgeons highlights the ongoing uncertainties and the best pragmatic options currently available for managing patients at risk for, or experiencing, MRONJ. Despite advances in clinical staging and case definitions, the precise pathogenesis of MRONJ remains elusive, and no definitive cures have been established. Preventive measures mainly focus on regular dental visits and ensuring dental clearance before initiating anti-resorptive therapy. Treatment approaches now give equal consideration to both operative and non-operative options based on clinical stage and patient preferences, ranging from surgical excision to palliative care with antibiotics and pain management. This can prove especially challenging to cancer patients, contributing to the morbidity and disease burden.
ORN poses a similar challenge to patients already impacted by cancer and the other side effects of its treatment, from surgery, chemotherapy and radiation.
The primary objective of this Research Topic is to address the unknowns, challenges, and opportunities in the management of ONJ, facilitating progress towards effective treatments and potential cures. Key areas include:
• Unveiling the mechanisms of MRONJ and ORN, which currently involve empirical understandings related to bone resorption, angiogenesis, and altered immune responses to microbial challenges.
• Exploration of the complex interplay between ionizing radiation, the microbiome and anti-tumor immunity; similarly, elucidation of the interplay between opportunistic pathogens/host microbiome and osteoimmunology in MRONJ
• Identifying genetic susceptibilities and personalized risk factors.
• Overcoming the difficulty in establishing effective animal models for translational research.
• Bridging the gap between promising findings in translational research and clinical trials.
• Validating osteoanabolic therapies through rigorous clinical research.
Recent advances suggest opportunities for large multicenter collaborative, interdisciplinary research to conduct prospective observational and interventional studies. Additionally, the development of emerging pre-clinical models for MRONJ offers new avenues for investigation.
This Research Topic invites contributions that explore the multifaceted aspects of MRONJ. Specific themes of interest include:
• Mechanisms and empirical understandings related to MRONJ.
• Genetic susceptibility and personalized risk prediction.
• Development and validation of animal models for MRONJ, expanding the scope for bioinformatic and translational exploration.
• Transition from translational research to clinical application.
• Validation of novel osteoanabolic therapies.
• Collaborative, interdisciplinary research initiatives and emerging pre-clinical models.
We welcome original research articles, clinical reports, case series, commentaries, and perspectives that shed light on these critical areas and help to remove existing roadblocks in the field of ONJ diagnosis and management.
Keywords:
medication-related osteonecrosis of the jaw, MRONJ, anti-resorptive therapy, pain management, osteoanabolic therapy, angiogenesis, bone resorption
Important Note:
All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.
The term ‘Osteonecrosis of the jaw (ONJ)’ encompasses rare complications affecting the jawbone, following exposure to radiation therapy (osteoradionecrosis, ORN) or medications such as anti-resorptive, anti-angiogenic medications, etc., collectively termed medication-related ONJ (MRONJ). Both entities present a significant diagnostic and therapeutic challenge in oral and maxillofacial surgery.
The recent update from the American Association of Oral and Maxillofacial Surgeons highlights the ongoing uncertainties and the best pragmatic options currently available for managing patients at risk for, or experiencing, MRONJ. Despite advances in clinical staging and case definitions, the precise pathogenesis of MRONJ remains elusive, and no definitive cures have been established. Preventive measures mainly focus on regular dental visits and ensuring dental clearance before initiating anti-resorptive therapy. Treatment approaches now give equal consideration to both operative and non-operative options based on clinical stage and patient preferences, ranging from surgical excision to palliative care with antibiotics and pain management. This can prove especially challenging to cancer patients, contributing to the morbidity and disease burden.
ORN poses a similar challenge to patients already impacted by cancer and the other side effects of its treatment, from surgery, chemotherapy and radiation.
The primary objective of this Research Topic is to address the unknowns, challenges, and opportunities in the management of ONJ, facilitating progress towards effective treatments and potential cures. Key areas include:
• Unveiling the mechanisms of MRONJ and ORN, which currently involve empirical understandings related to bone resorption, angiogenesis, and altered immune responses to microbial challenges.
• Exploration of the complex interplay between ionizing radiation, the microbiome and anti-tumor immunity; similarly, elucidation of the interplay between opportunistic pathogens/host microbiome and osteoimmunology in MRONJ
• Identifying genetic susceptibilities and personalized risk factors.
• Overcoming the difficulty in establishing effective animal models for translational research.
• Bridging the gap between promising findings in translational research and clinical trials.
• Validating osteoanabolic therapies through rigorous clinical research.
Recent advances suggest opportunities for large multicenter collaborative, interdisciplinary research to conduct prospective observational and interventional studies. Additionally, the development of emerging pre-clinical models for MRONJ offers new avenues for investigation.
This Research Topic invites contributions that explore the multifaceted aspects of MRONJ. Specific themes of interest include:
• Mechanisms and empirical understandings related to MRONJ.
• Genetic susceptibility and personalized risk prediction.
• Development and validation of animal models for MRONJ, expanding the scope for bioinformatic and translational exploration.
• Transition from translational research to clinical application.
• Validation of novel osteoanabolic therapies.
• Collaborative, interdisciplinary research initiatives and emerging pre-clinical models.
We welcome original research articles, clinical reports, case series, commentaries, and perspectives that shed light on these critical areas and help to remove existing roadblocks in the field of ONJ diagnosis and management.
Keywords:
medication-related osteonecrosis of the jaw, MRONJ, anti-resorptive therapy, pain management, osteoanabolic therapy, angiogenesis, bone resorption
Important Note:
All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.