Medication Related Osteonecrosis of the Jaws: Current Controversies Based on a 12 Year Experience of a Tertiary Center

Objectives: Medication related osteonecrosis of the jaws is a recently described pathologic entity which has provoked a lot of scientific work since the first publication on 2003. Our study focused on the role of prevention and the efficacy of treatment that we offered to the patients suffering from MRONJ.

Methods: The study covers a period of 12 years of treating patients with MRONJ either pos or iv delivered. On the same time a number of patients who were candidates to take antiosteolytic – antiresorptive drugs had a consultation with the author in order to perform good oral hygiene and having dental examination before the delivery of them. The disease for which the agent was given was recorded for each patient together with the duration of administration and the follow up. The patients were classified according to the offered treatment ( surgical- conservative ) and the efficacy of it.

Results: The vast majority of the 149 patients diagnosed with MRONJ had taken antiosteolytic – antiresorptive agents due to a malignant disease followed by the patients suffering from osteoporosis. The women were 110 and men 39 accordingly. The patients who were operated did not have any sign of recurrence or postoperative infection. A total of 232 patients were examined before the administration of the drugs and only 3 of them suffered from MRONJ during this 12 year period.

Conclusions: Prevention is the only tool that can reduce the incidence of MRONJ. In patients suffering from this condition operative treatment is accompanied by almost permanent results comparing with the conservative approach.