Infectious/Inflammatory Oral Diseases and Medication-Related Osteonecrosis of the Jaw (MRONJ)

Medication-related osteonecrosis of the jaw (MRONJ) is a rare and potentially debilitating condition affecting patients treated with medications that inhibit bone resorption. It is characterized by exposed bone, usually in the mandible or maxilla, with clinical signs of inflammation, pain, and local infection. MRONJ is often triggered by invasive procedures in the oral cavity, such as dental extractions or trauma, and is associated with a predisposition to secondary infections. The interaction between MRONJ and oral infectious/inflammatory diseases, such as periodontal disease, apical periodontitis, and peri-implantitis, is complex, as oral infections lead to bone infection, exacerbating the bone necrosis characteristic of MRONJ. Furthermore, the inflammatory process of oral infections can worsen the patient's immune response and hinder the healing of bone lesions. The clinical management of patients with MRONJ resulting from oral infections requires a careful approach, with emphasis on strict control of the infection and preservation of periodontal health. Prevention and control of oral infections are essential to minimize the risk of complications and improve the patient's quality of life. This chapter addresses the relationship between MRONJ and different oral infections, presenting current aspects of this relationship and special care for its treatment.