<abstract xmlns="http://www.w3.org/1999/xhtml">

Medication-Related Osteonecrosis of the Jaw (MRONJ) is defined as a complication, which affects the jawbone of patients that meet all of the following criteria: (a) patients were in the past or are now on treatment with bone targeting agents (BTAs) and/or antiangiogenics, (b) they have exposed bone or bone that can be probed through an intraoral or extraoral fistula for more than 8 weeks, and (c) they have no history of radiotherapy or obvious metastatic disease to the jaws.
Since the first reports, in 2003, plethora of articles on MRONJ significantly increased our knowledge of this potentially serious complication. However, controversies about the definition and clinical presentation, risk factors, radiological findings, staging and early diagnosis, prevention and treatment may affect the successful management and the quality of life of cancer patients. The purpose of this article is to present the current knowledge about MRONJ and the recent advances to best clinical practice and treatment.
Important questions will be discussed, including the following: (1) Should we wait for 8 weeks when a patient on antiresorptive therapy, presents with exposed necrotic jawbone? (2) Can we exclude the diagnosis of osteonecrosis if a patient presents without exposed bone? (3) Is the dental extraction a risk factor for MRONJ? (4) Should we perform the dental extraction, when a patient on antiresorptives, presents with a symptomatic tooth? (5) What is the role of dental or periodontal infection? (6) Shall we re-start the antiresorptives following healing of previous MRONJ?
</abstract>

Medication-Related Osteonecrosis of the Jaw (MRONJ) is defined as a complication, which affects the jawbone of patients that meet all of the following criteria: (a) patients were in the past or are now on treatment with bone targeting agents (BTAs) and/or antiangiogenics, (b) they have exposed bone or bone that can be probed through an intraoral or extraoral fistula for more than 8 weeks, and (c) they have no history of radiotherapy or obvious metastatic disease to the jaws.
Since the first reports, in 2003, plethora of articles on MRONJ significantly increased our knowledge of this potentially serious complication. However, controversies about the definition and clinical presentation, risk factors, radiological findings, staging and early diagnosis, prevention and treatment may affect the successful management and the quality of life of cancer patients. The purpose of this article is to present the current knowledge about MRONJ and the recent advances to best clinical practice and treatment.
Important questions will be discussed, including the following: (1) Should we wait for 8 weeks when a patient on antiresorptive therapy, presents with exposed necrotic jawbone? (2) Can we exclude the diagnosis of osteonecrosis if a patient presents without exposed bone? (3) Is the dental extraction a risk factor for MRONJ? (4) Should we perform the dental extraction, when a patient on antiresorptives, presents with a symptomatic tooth? (5) What is the role of dental or periodontal infection? (6) Shall we re-start the antiresorptives following healing of previous MRONJ?

Medication Related Osteonecrosis of the Jaw (MRONJ). Review and recent advances

Oral Diagnosis and Radiology Clinic, Dental School

National and Kapodistrian University of Athens

Department of Oncology, B Propaideytiki Pathology Clinic, Peripheral General Hospital of Athens Attikon, School of Medicine

Forum of Clinical Oncology

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

{"article-title":"Medication Related Osteonecrosis of the Jaw (MRONJ). Review and recent advances"}

Medication-Related Osteonecrosis of the Jaw (MRONJ) is defined as a complication, which affects the jawbone of patients that meet all of the following...

Medication Related Osteonecrosis of the Jaw (MRONJ). Review and recent advances

Article Category: Review

Published Online: Mar 27, 2023

Page range: 38 - 47

Received: Mar 22, 2018

Accepted: Mar 17, 2019

DOI: https://doi.org/10.2478/fco-2022-0005

Keywords
osteonecrosis of the jaw, clinical presentation, radiographical findings, risk factors, prevention, dental extraction, infection, management

© 2022 Dimitra Galiti et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Medication Related Osteonecrosis of the Jaw (MRONJ). Review and recent advances

Article Category: Review

Published Online: Mar 27, 2023

Page range: 38 - 47

Received: Mar 22, 2018

Accepted: Mar 17, 2019

DOI: https://doi.org/10.2478/fco-2022-0005

Keywordsosteonecrosis of the jaw, clinical presentation, radiographical findings, risk factors, prevention, dental extraction, infection, management

© 2022 Dimitra Galiti et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Keywords
osteonecrosis of the jaw, clinical presentation, radiographical findings, risk factors, prevention, dental extraction, infection, management