Medication-Related Osteonecrosis of the Jaw (MRONJ): Why Every Dentist Should Be Aware

Pharmacy
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Medication-Related Osteonecrosis of the Jaw (MRONJ) is a rare but serious complication associated with anti-resorptive drugs, such as bisphosphonates and denosumab and antiangiogenic agents

These are used to treat osteoporosis, bone metastases, and certain cancers.

MRONJ is characterised by persistent exposed bone in the jaw for more than 8 weeks in patients taking these medications. Patient shouldn’t have history of radiation therapy to the jaws. ( To rule out osteoradionecrosis)

Common Risk Factors

  • Tooth extraction or other invasive dental procedures

  • Untreated periodontitis

  • Poor oral hygiene

  • Long-term or intravenous antiresorptive therapy

  • Smoking, diabetes, and corticosteroid use

The jaw has a high rate of bone remodelling. These medications suppress normal bone turnover, making healing difficult after trauma or infection and increasing the risk of bone necrosis.

Prevention

  • Taking a thorough medication history.

  • Treating periodontal disease and oral infections before starting therapy.

  • Promoting excellent oral hygiene and regular dental check-ups.

  • Avoiding unnecessary invasive procedures whenever possible.

Although MRONJ is uncommon, early identification of at-risk patients and preventive dental care can significantly reduce its occurrence.

There are so many complications related to many drugs, so taking complete medical history is very important.

Comment your opinion and thoughts in comment section.

MBH/PS

3 Likes
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Thank you for sharing this!!! As someone with a dental background… I feel this is a topic that deserves more attention. It reinforces how critical detailed history taking and preventive care are in minimizing the risk of MRONJ.

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Thank you for putting it simple, the associated risk factors and prevention. Taking proper medical history guides you towards a better prognosis, whatever the condition is.

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Thank you, for sharing the details of MRONJ, associated treatment and its complications. Most of the times, the drug use for the treatment have more sever side effects than its efficacy.

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Yes very rightly said and we need to consider all that before starting any treatment

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Definitely taking medical history is very important in treatment planning

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Yes as dentist we should understand that medical history has affects oral health. Taking medical history also helps to improve treatment plan

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