Medication-Related Osteonecrosis of the Jaw: A Reflection of Current Preventative and Therapeutic Guidelines: A Review

Medication-related osteonecrosis of the jaw (MRONJ) is a serious side effect of bisphosphonates, denosumab, and antiangiogenic drugs. Although the literature is rich with research work discussing MRONJ, the pathogenesis of this devastating condition has not been adequately understood yet. Roles of infection, immunity and genetic predisposition have been extremely unclear. Moreover, many controversies have been governing risk assessment and management guidelines. In 2003, 36 cases of osteonecrosis of the jaw (ONJ) associated with the use of either pamidronate or zoledronate were reported. Furthermore, in 2014, the American Association of Oral and Maxillofacial Surgeons (AAOMS) suggested the term “medication-related osteonecrosis of the jaw” (MRONJ) to describe jaw osteonecrosis related to the use of medications. This review sheds the light on recent research work discussing the pathogenesis of MRONJ. Moreover, it suggests possible guidelines for risk assessment and management based on information gathered from different research papers found in the literature.