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Review
. 2016 Oct 28;4(4):38.
doi: 10.3390/dj4040038.

Current Controversies on the Pathogenesis of Medication-Related Osteonecrosis of the Jaw

Winnie Zee Man Wat  1
Affiliations
Review

Current Controversies on the Pathogenesis of Medication-Related Osteonecrosis of the Jaw

Winnie Zee Man Wat. Dent J (Basel). .

Abstract

Medication-related osteonecrosis of the jaw (MRONJ) was first reported more than a decade ago. Since then, numerous cases have been diagnosed. Currently, there are three groups of drugs related to MRONJ: bisphosphonates, denosumab and anti-angiogenic drugs. As MRONJ can lead to debilitating clinical sequels and limited effective treatment options are available, much research has been done in understanding its pathophysiology. Until now, the exact pathogenesis of MRONJ has not been fully elucidated. While history of invasive dental procedures or local trauma may be present, some cases occur spontaneously without any preceding factors. This review aims to examine and discuss the three main hypotheses for the pathogenesis of MRONJ, namely suppressed bone turnover, cellular toxicity and infection.

Keywords: BRONJ; DRONJ; MRONJ; anti-angiogenic; bisphosphonate; denosumab; osteonecrosis of the jaw; zoledronate.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
The mechanisms of action of bisphosphonates and denosumab.
Figure 2
Figure 2
Flowchart shows the current hypothesis of the pathophysiology of MRONJ.
See this image and copyright information in PMC

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