STAGES AND PATHOPHYSIOLOGICAL MECHANISMS OF ACTION OF MRONJ
STAGES AND PATHOPHYSIOLOGICAL MECHANISMS OF ACTION OF MRONJ

Summary/Abstract: Medication-related osteonecrosis of the jaw (MRONJ) is a rare but severe disabling condition. The first case of MRONJ was reported by Marx in the early 2000s in a study of non-healing open bone in the maxillofacial area of a patient treated with bisphosphonate. The MRONJ placement system was developed in 2006 by Ruggiero et al. and subsequently adopted by American Association of Oral and Maxillofacial Surgeons (AAOMS) and updated in 2014. In at-risk asymptomatic patients without visible necrotic bone with a history of previous antiresorptive or antiangiogenic therapy, no treatment is recommended but only patient information on the risk of developing osteonecrosis and clinical signs and symptoms of this disease. Patients with established MRONJ are treated differently; the goals of treatment are mainly to control pain, infection and the progression of bone necrosis. Despite the strong association between jaw necrosis and bisphosphonates and other antiresorptive and antiangiogenic drugs, the pathophysiology of MRONJ is not fully understood.

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