West China Journal of Stomatology ›› 2021, Vol. 39 ›› Issue (3): 245-254.doi: 10.7518/hxkq.2021.03.001

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Mechanism, prevention, and treatment for medication-related osteonecrosis of the jaws

Pan Jian(), Liu Jiyuan   

  1. State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
  • Received:2020-09-02 Revised:2021-04-08 Online:2021-06-01 Published:2021-05-26
  • Contact: Pan Jian E-mail:jianpancn@163.com
  • Supported by:
    Science and Technology Program of Sichuan Province(2020YFS0182);Clinical Research Program of West China Hospital of Stomatology, Sichuan University(LCYJ2019-1)


The morbidity rate of medication-related osteonecrosis of the jaws (MRONJ) increased rapidly in recent years. Thusfar, the mechanism of MRONJ has no consensus. The possible mechanisms may include bone remodeling inhibition theory, angiogenesis inhibition theory, oral microorganism infection theory, immunosuppression theory, cytotoxicity-targeted oral epithelial cells, microcrack formation of maxillary or mandibular bone, and single nucleotide polymorphism. However, the efficacy of prevention and treatment based on a single mechanism is not ideal. Routine oral examination before MRONJ-related drug treatment, treatment of related dental diseases, and regular oral follow-up during drug treatment are of great significance for the prevention of MRONJ. During the treatment of MRONJ, the stage of MRONJ must be determined accurately, treatment must be standardized in accordance with the guidelines, and personalized adjustments must be made considering the specific conditions of patients. This review aimed to combine the latest research and guidelines for MRONJ and the experiences on the treatment of MRONJ in the Maxillofacial Surgery Department of West China Hospital of Stomatology, Sichuan University, and discuss the strategies to improve the clinical process.

Key words: medication-related osteonecrosis of the jaws, mechanism, prevention, diagnosis, treatment

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