Table 2.
Main dental treatments with respect to patients' categories in the pre-treatment phase with drugs related to ONJ.
| Dental procedures on patients in the pre-treatment phase | Cancer patients | Non-cancer patients |
|---|---|---|
| Non-Surgical Procedures | ||
| Restorative dentistry | Indicated | Indicated |
| Endodontic treatment | Indicated | Indicated |
| Orthodontic treatment | Possible | Possible |
| Periodontal treatments: oral hygiene and non-surgical treatments | Indicated | Indicated |
| Prosthesis | Possible | Possible |
| Surgical Procedures | ||
| Dentoalveolar surgery | Indicated∗ | Indicated |
| Preimplant bone surgery | Contraindicated | Possible★ |
| Dental implant surgery | Contraindicated | Possible★ |
| Periodontal/endodontic surgery | Indicated§ | Indicated§ |
∗Advisable to wait for wound healing (4–6 weeks) before initiating antiresorptive or antiangiogenic treatment for cancer therapy. When treatment with ONJ-related drugs cannot be deferred, dentoalveolar surgery is indicated; in this case, the surgical protocol and medical treatment of oncological patients already in-treatment with MRONJ-related drugs will also be performed. §To Perform only if any infective processes cannot be treated via periodontal/endodontic, non-invasive treatment. ★Advise the patient that the risk of MRONJ is indefinable in the long term.