[Osteonecrosis of the jaws]

Area of Science:

• Oral and Maxillofacial Surgery
• Pharmacology
• Oncology

Background:

• Medication-related osteonecrosis of the jaw (MRONJ) is characterized by exposed necrotic bone in the maxillofacial region.
• It is frequently associated with the use of bone-modifying agents such as bisphosphonates and denosumab for osteoporosis and cancer treatment.
• The exact etiology of MRONJ remains unclear but is hypothesized to involve suppressed bone turnover, increasing susceptibility to necrosis during dental procedures.

Purpose of the Study:

• To review the main characteristics of drug-related osteonecrosis of the jaws.
• To present a literature review on the primary features of MRONJ.
• To propose evidence-based prevention and treatment strategies for patients with MRONJ.

Main Methods:

• A comprehensive literature review was conducted.
• Studies focusing on bisphosphonates, denosumab, and MRONJ were systematically analyzed.
• Clinical characteristics, risk factors, and management approaches were synthesized.

Main Results:

• MRONJ presents as exposed, necrotic bone in the jaw, often following invasive dental procedures.
• The condition is strongly linked to antiresorptive and antiangiogenic medications.
• Current literature lacks consensus on standardized prevention and treatment protocols.

Conclusions:

• MRONJ is a significant complication associated with specific medications used for bone conditions.
• Further research is needed to elucidate the pathophysiology and establish definitive management guidelines.
• A proactive approach to prevention and treatment is crucial for affected patients.