Treatment of Medication-Related Osteonecrosis of the Jaw: Controversies in Causality and Therapy

Abstract

Medication-related osteonecrosis of the jaw (MRONJ) is a most interesting, complex and "elusive" condition seen by the oral health care provider. It is plagued by controversy and although a wealth of research has created clinical treatment databases, there is no "gold standard" algorithm to be applied in a universal fashion. The purpose of this article is to explore several controversies associated with the etiology(s), staging, treatments, and long-term resolution of MRONJ in patients who are treated by the oral health care provider. Controversies for optimizing prevention, and disease control will also be discussed from an interdisciplinary perspective.

Keywords: Antiresorptive drugs; Bisphosphonates; Controversy; Denosumab; Drug holiday; MRONJ; MRONJ staging; Medication-related osteonecrosis of the jaw.