Review Article

Osteonecrosis of the Jaw Associated with Antiangiogenics in Antiresorptive-Naïve Patient: A Comprehensive Review of the Literature

Table 3

Summary of data of reported cases of antiangiogenic-related MRONJ ().

Age (years, range)
 Mean59.06 (33–80)
Gender (, %)
 Male19 (54.29%)
 Female14 (40.00%)
 NA2 (5.71%)
Diagnosis of cancers (, %)
 Metastatic renal cell cancer10 (28.57%)
 Metastatic colorectal cancer6 (17.14%)
 Metastatic breast cancer5 (14.29%)
 Other cancers14 (40.00%)
  Metastatic non-small-cell lung cancer4
  Glioblastoma multiforme2
  Medullary thyroid cancer2
  Malignant parotid tumour1
  Pancreatic cancer1
  Metastatic hepatocellular carcinoma1
  Metastatic carcinoid cancer1
  Metastatic oesophageal cancer1
Presenting complaints (, %)
 Jaw pain12 (34.29%)
 Jaw pain with other complaints6 (17.14%)
 Asymptomatic8 (22.86%)
 Jaw discomfort1 (2.86%)
 Spontaneous teeth loss1 (2.86%)
 Limited mouth opening and submandibular area swelling1 (2.86%)
 Gingival bleeding1 (2.86%)
 NA5 (14.29%)
Clinical presentation (, %)
 Bone exposure MRONJ32 (91.43%)
 Nonexposed MRONJ3 (8.57%)
Location
 Mandible29 (82.86%)
 Maxilla4 (11.43%)
 NA2 (6.67%)
Types of antiangiogenic agents (, %)
 Bevacizumab14 (40%)
 Aflibercept5 (14.29%)
 Sunitinib3 (8.57%)
 Cabozantinib2 (5.71%)
 Sorafenib1 (2.86%)
 Temsirolimus1 (2.86%)
 Everolimus1 (2.86%)
 Dasatinib1 (2.86%)
 Multiple antiangiogenic agents7 (20.00%)
Route of antiangiogenic administrations (, %)
 Intravenous administration21 (60.00%)
 Oral administration12 (34.29%)
 Combination of intravenous administration and oral administration2 (5.71%)
Time to MRONJ (months, 95% CI)
 Intravenous antiangiogenics6.49 (2.67–10.30)
 Oral antiangiogenics16.72 (2.59–30.84)
Predisposing factors (, %)
 Extraction13 (37.14%)
 Periodontal disease3 (8.57%)
 Minor trauma from use of denture4 (11.43%)
 Dental implant1 (2.86%)
 Mean time to MRONJ after extraction (months, 95% CI)3.09 (0.40–5.77)
Management of MRONJ (, %)
 Surgical treatment17 (48.57%)
  Minimally invasive surgical procedures11
  Major surgical procedures6
 Nonsurgical treatment16 (45.71%)
 No treatment1 (2.86%)
 NA1 (2.86%)
Treatment outcomes (, %)
 Disease resolution18 (62.06%)
 Mean time to resolution (months, 95% CI)6.75 (0.90–12.59)
 Incomplete resolution11 (37.93%)
 NA6

NA: not available.