Ling-Ying WEI
Anti-resorptive agents, such as bisphosphonates or denosumab, that potently inhibit osteoclast‐mediated bone resorption are commonly used in patients with osteoporosis, cancer with bone metastasis, or multiple myeloma. The alteration of bone turnover and suppression of remodeling by antiresorptive agents impair wound healing of jaw bones and potentially result in an adverse event which was termed medication-related osteonecrosis of the jaws (MRONJ). Prevalence and risk factors for MRONJ have been extensively investigated in recent years, but a relatively small number of studies focused on the treatment outcomes of MRONJ patients. The American Association of Oral and Maxillofacial Surgeons (AAOMS)’s position paper on MRONJ in 2022 posed a series of algorithms for treatment strategies and emphasized that both nonoperative and operative management are acceptable for all stages of disease in a shared decision-making model. However, surgeons and patients sometimes face a dilemma while determining treatment options. In this section, we will discuss the prognostic factors of MRONJ patients and how effective operative therapy is, as compared to non-operative therapy at promoting outcomes.
