Medication-Related Osteonecrosis of the Jaw: Risk Factors, Management and Prevention in Dental Practices

Year 2025, Volume: 6 Issue: 1, 26 - 36, 31.01.2025

Osayd Alawawda , Gelengül Urvasızoğlu , Funda Bayındır

https://doi.org/10.56766/ntms.1528563

Abstract

Medication-related osteonecrosis of the jaw (MRONJ) is a major clinical problem that particularly affects patients receiving antiresorptive therapy for primary or metastatic bone malignancies and osteoporosis. The incidence of MRONJ varies by drug type and route of administration, with a higher incidence observed in patients receiving intravenous bisphosphonate therapy. This review examines the risk factors, management strategies and preventive measures for MRONJ, emphasizing the impact tooth extraction, implant treatment, oral surgery, periodontitis and poorly fitting removable dentures. Dental implants have been shown to have different risks for MRONJ, and some studies show that they do not significantly increase the risk of MRONJ and may even decrease it compared to other dental procedures. On the other hand, tooth extraction remains an important local risk factor for MRONJ and requires careful planning and execution to minimize trauma and subsequent complications. Effective prevention and treatment of MRONJ requires a multifaceted approach, including a thorough pretreatment dental evaluation, careful oral hygiene, and less traumatic dental procedures. Collaboration between dentists, physicians and patients is critical to optimize outcomes and minimize the risk of MRONJ. In addition, increasing knowledge and awareness of MRONJ among healthcare providers and patients is important for early detection and prevention. Future research should aim to further elucidate the pathophysiology of MRONJ and develop targeted treatment and complex prevention strategies. By advancing the understanding and treatment of MRONJ, dentists can provide safer and more effective treatment for patients undergoing antiresorptive therapy, ultimately improving their quality of life.

Keywords

Medication-Related Osteonecrosis of the Jaw (MRONJ), Antiresorptive therapy, Dental implants, Tooth extraction, Bisphosphonates (BPs)

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