Medication-related osteonecrosis of the jaw treatment modalities: A review

Medication-related osteonecrosis of the jaw (MRONJ) is a serious adverse reaction of antiresorptive and antiangiogenic agents. Management of MRONJ has remained a controversial topic within the oral and maxillofacial surgery community.

Articles from 2010 to 2020 were selected. We determined that all review studies evaluated the effectiveness of various MRONJ therapies to resolve the condition were eligible for this study. We determined that all review studies evaluated the effectiveness of various MRONJ therapies to resolve the condition were eligible for this study.

Antibiotic therapy such as penicillin-based antibiotics plus β-lactamase inhibitor or metronidazole could decrease disease progression and may prevent super infection of the bone. Surgery should be considered in all stages of MRONJ as it confirms the histology. Fluorescence-guided surgery is helpful for MRONJ cases under Denosumab and it is recommended to use low level laser and PDT as adjuvant treatment of MRONJ.

It seems that conservative treatment, minimally traumatic extraction technique, removal of bone edges and mucosal wound closure may prevent the occurrence of MRONJ.
Keywords: Mronj; Bronj; Treatment; Prevention.