There is no direct causal link between ABRT and the development of ONJ, and additional risk factors, such as dental procedures, are likely to be important in the development of this disease.
A tooth extraction while on ABRT is widely reported as one of the greatest risk factors for the development of ABRT-ONJ (Barasch et al., 2013; Boonyapakorn et al., 2008; Fehm et al., 2009; Henry et al., 2011).
In Part II of this article, we present data suggesting many adult patients have poor dentition before starting ABRT and should be assessed by a dental practitioner prior to treatment initiation.
Anti-angiogenic agents are sometimes prescribed alongside ABRT. Data collated from patients receiving sunitinib or bevacizumab provides compelling evidence that anti-angiogenic agents may be involved in the development of ONJ, or act as risk factors for the disease in patients receiving ABRT (AragonChing et al., 2009; Bozas, Roy, Ramasamy, & Maraveyas, 2010; Sharma et al., 2012).
Data for corticosteroid use with ABRT are contradictory.