Medication-Related Osteonecrosis of the Jaw: An Overview

Abstract

Medication-related osteonecrosis of the jaw (MRONJ) is a rare side effect of medications belonging to the antiresorptive (AR) and antiangiogenic (AA) groups. The first cases were described in the literature in 2003, and more than 1300 publications and 15,000 cases have been published since then. The incidence of MRONJ among cancer patients treated with bisphosphonates is 0–6.7%, with denosumab is 0.7–1.7% and with bevacizumab is 0.2%. Patients treated for osteoporosis have a lower risk of developing MRONJ at 0.02 and 0.04% with bisphosphonates and 0.2% with denosumab. In more than 50% of cases, tooth extraction was considered the causative factor responsible for the onset of the MRONJ. Treatment strategies include preventive, medical and surgical interventions.