Eur J Musculoskel Dis 2025 Sep-Dec;14(3):119-127
ARTICLE
OSTEONECROSIS OF THE JAWS. ANALYSIS OF RISK FACTORS AND DENTAL MANAGEMENT STRATEGIES- PART II
M. Scarpati Cioffari di Castiglione1, S. Lauri2*, C. Moscetta3, F. Ferrantini4, L.M. Laudiero4, G.M. Granata4, V.M. Spadoni4 and I. Mastrorilli5
1 Independent researcher, 81021, Caserta, Italy;
2 Independent researcher, 00073, Rome, Italy;
3 Independent researcher, 03018, Frosinone, Italy;
4 Department of System Medicine, University of Rome “Tor Vergata”, Rome, Italy;
3 Independent Researcher, 00135, Rome, Italy.
*Correspondence to:
Simone Lauri,
Independent Researcher,
00073, Rome, Italy.
e-mail: laurisimone1@gmail.com
| Received: 04 September, 2025 Accepted: 27 October, 2025
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ISSN 2975-044X (online) ISSN 2038-4106 (print) Copyright © by BIOLIFE 2025 This publication and/or article is for individual use only and may not be further reproduced without written permission from the copyright holder. Unauthorized reproduction may result in financial and other penalties. Disclosure: All authors report no conflicts of interest relevant to this article. |
ABSTRACT
Introduction: Medication-related osteonecrosis of the jaw (MRONJ) presents a significant clinical challenge due to the increasing use of anti-resorptive drugs. Characterized by exposed necrotic bone, pain, and infection, MRONJ requires a multidisciplinary approach. This review aims to synthesize current evidence and emerging innovations in the surgical and medical management of MRONJ. Materials and Methods: A critical review of the existing scientific literature on MRONJ was conducted, using electronic databases such as PubMed, Scopus, and Google Scholar. Extracted information was organized by thematic categories, synthesized, and critically analyzed for a comprehensive overview. Discussion: The surgical protocol involves careful preoperative evaluation, professional oral hygiene, and the use of antiseptic mouthwashes. Surgical techniques range from debridement and curettage to aggressive resection, with the aim of completely removing necrotic tissue. New protocols integrate laser photobiomodulation, platelet-rich plasma, and deferoxamine to promote tissue regeneration. Suspension of anti-resorptive therapy, in agreement with the attending physician, is crucial. Treatment can be surgical and non-surgical. Conclusions: Optimal management of MRONJ requires a personalized, multidisciplinary approach. Implementing preventive protocols, early diagnosis, and adopting updated treatments, combining conservative and surgical strategies, are key to reducing the incidence of MRONJ and improving the quality of life for affected patients.
KEYWORDS: MRONJ, bisphosphonate, regenerative therapy, oral surgery, therapeutic innovation
