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Updated: Oct 21, 2025

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Recurrence-Related Factors of Medication-Related Osteonecrosis of the Jaw: A Five-Year Experience

Shuo Chen1, Hongyu Ren2, Yang He3

  • 1Attending, Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, National Center of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, PR China.

Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons
|September 5, 2021
PubMed
Abstract

Insights

Medication-related osteonecrosis of the jaw (MRONJ) treatment is challenging. Prolonged zoledronic acid use over 18 months significantly increases MRONJ recurrence risk in patients.

Area of Science:

  • Oral and Maxillofacial Surgery
  • Pharmacology
  • Oncology

Background:

  • Medication-related osteonecrosis of the jaw (MRONJ) presents a significant clinical challenge.
  • Identifying recurrence risk factors is crucial for effective patient management.

Purpose of the Study:

  • To review patients with MRONJ treated at our institution over a five-year period.
  • To explore risk factors associated with MRONJ recurrence following treatment.

Main Methods:

  • Retrospective cohort study of 58 patients (62 sites) with MRONJ treated between January 2016 and December 2020.
  • Analysis of patient data including monthly intravenous zoledronic acid administration.
  • Multivariate logistic regression to identify predictors of treatment recurrence.

Main Results:

  • The duration of zoledronic acid medication exceeding 18 months was identified as a significant risk factor for MRONJ recurrence.
  • An odds ratio of 7.346 (95% CI: 1.461-36.946, P=.016) was associated with medication duration over 18 months.

Conclusions:

  • Extended use of zoledronic acid (over 18 months) may elevate the risk of MRONJ recurrence.
  • Clinical guidelines may need to consider medication duration when managing MRONJ patients.

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