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Identified Medications Causing Medication-Related Osteonecrosis of the Jaw: A Literature Review
Nasimeh Baghalipour1, Omid Moztarzadeh1,2, Christos Micopulos1
1Department of Stomatology, Faculty of Medicine in Pilsen, Charles University, University Hospital Pilsen, Pilsen, CZE.
Abstract:
Medication-related osteonecrosis of the jaw (MRONJ) is a serious adverse event that occurs in patients treated with certain medications, leading to a major side effect that can result in substantial morbidity. MRONJ is known to be associated with antiresorptive (AR) and antiangiogenic (AA) medicines, but recent evidence suggests that other medications may also be involved. Recognizing a broad range of drug-induced risk factors is important, notably in light of the increasing number of drugs associated with MRONJ. The primary objective of this review is to update and synthesize findings from the past 22 years (2003 to April 2025) regarding medications associated with MRONJ, expanding beyond the traditional AR and AA drugs to include more recent and developing therapeutic classes. This review combines findings from recent literature, including studies on AR and AA medications, as well as other drug classes, such as targeted cancer therapies and immunomodulatory agents. This review provides updated insights into MRONJ for healthcare practitioners and dentists, emphasizing the significance of risk assessment, early recognition, and multidisciplinary management to improve patient care and outcomes. Given its potential to cause significant morbidity and complicate dental and medical treatments, MRONJ presents a critical concern in clinical practice, underscoring the need for heightened awareness among healthcare professionals.
Insights
Medication-related osteonecrosis of the jaw (MRONJ) is a serious side effect linked to antiresorptive and antiangiogenic drugs. This review expands understanding to include newer drug classes, emphasizing risk assessment and multidisciplinary care for better patient outcomes.
Area of Science:
- Oral and Maxillofacial Surgery
- Pharmacology
- Oncology
Background:
- Medication-related osteonecrosis of the jaw (MRONJ) is a significant adverse event associated with antiresorptive (AR) and antiangiogenic (AA) medications.
- Emerging evidence indicates a broader spectrum of drugs, including targeted cancer therapies and immunomodulatory agents, may also contribute to MRONJ.
- The increasing number of implicated medications necessitates an updated understanding of drug-induced risk factors.
Purpose of the Study:
- To comprehensively review and synthesize literature from 2003 to April 2025 on medications associated with MRONJ.
- To expand the scope beyond traditional AR and AA drugs to include recently identified therapeutic classes.
- To provide healthcare practitioners and dentists with updated insights for improved patient management.
Main Methods:
- Systematic literature review of studies published between 2003 and April 2025.
- Inclusion of research on traditional AR and AA medications.
- Analysis of studies investigating newer drug classes implicated in MRONJ.
Main Results:
- Identification of a widening range of medications linked to MRONJ, extending beyond AR and AA agents.
- Synthesis of current evidence on drug-induced risk factors for MRONJ.
- Highlighting the role of targeted cancer therapies and immunomodulatory agents in MRONJ development.
Conclusions:
- MRONJ is a critical clinical concern with potential for substantial morbidity, complicating dental and medical treatments.
- Heightened awareness of diverse drug-induced risk factors is crucial for healthcare professionals.
- Effective management hinges on robust risk assessment, early recognition, and a multidisciplinary approach to optimize patient care and outcomes.
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