MRONJ: Stage 3, The Best Moment To Develop Surgery Techniques

Abstract

Antiresorptives (bisphosphonates: BPs, denosumab: DS)induce a marked inhibition of bone resorption. Low concentrations are used to treat osteoporosis (OP) or other metabolic bone diseases including osteopenia. Besides, high concentrations are primarily used as an effective treatment in the management of cancer-related disorders, including hypercalcemia of malignant and skeletal-related events associated with bone metastases. MRONJ (Medication Related Osteonecrosis of the Jaw) is one of the most serious therapy complications with such drugs. In this regard, although the pathogenesis of MRONJ is not understood yet, several papers suggest that antiresorptives may play a role in its development [1]. According to the American Association of Oral and Maxillofacial Surgeons (AAOMS, 2014), MRONJ is defined as exposed or necrotic bone in the maxillofacial region that has persisted for more than 8 weeks in association with