Medication-related osteonecrosis of the jaw: definition and best practice for prevention, diagnosis, and treatment

Ourania Nicolatou-Galitis, Morten Schiødt, Rui Amaral Mendes, Carla Ripamonti, Sally Hope, Lawrence Drudge-Coates, Daniela Niepel, Tim Van den Wyngaert

Research output: Contribution to journalReview articlepeer-review


Skeletal complications caused by osteoporosis or bone metastases are associated with considerable pain, increased mortality, and reduced quality of life. Furthermore, such events place a burden on health care resources. Agents that prevent bone resorption, such as bisphosphonates or denosumab, can reduce the risk of skeletal-related events and are widely used in patients with osteoporosis or bone metastases of cancer. Medication-related osteonecrosis of the jaw (MRONJ) is a rare, but potentially serious, adverse event associated with high cumulative doses of bisphosphonates or denosumab. However, MRONJ can be treated, and the likelihood of the development of this condition can be reduced through prophylactic dental care and the maintenance of good oral hygiene. Dentists, as part of a multiprofessional team, have a critical role in preventing MRONJ. This review describes the incidence and pathophysiology of MRONJ and provides guidance for dental practitioners with regard to the screening, prophylactic treatment, diagnosis, and management of patients with this condition.

Original languageEnglish
Pages (from-to)117-135
Number of pages19
JournalOral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Issue number2
Publication statusPublished - Feb 2019

ASJC Scopus subject areas

  • Surgery
  • Oral Surgery
  • Pathology and Forensic Medicine
  • Dentistry (miscellaneous)
  • Radiology Nuclear Medicine and imaging


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