Cookies on this website
We use cookies to ensure that we give you the best experience on our website. If you click 'Continue' we'll assume that you are happy to receive all cookies and you won't see this message again. Click 'Find out more' for information on how to change your cookie settings.

Medication-related osteonecrosis of the jaw (MRONJ), although initially believed to be exclusively associated with bisphosphonates, has been implicated in recent reports with additional drugs, especially the bone antiresorptive denosumab. The pathophysiology has not been fully elucidated, and no causal association between bone antiresorptive regimens and MRONJ has yet been established. However, reduced bone turnover and infection, an almost universal finding, are thought to be central to the pathogenesis of MRONJ. Both bisphosphonates and denosumab, through different pathways of action, significantly reduce the rate of bone turnover and potentially reduce the efficacy of the host defense against infection. Recent evidence questions the simplified etiology of low bone turnover causing MRONJ and offers evidence on the prominent role of infection instead. The management of MRONJ remains a significant clinical challenge, with little progress having been made on treatment. The aim of this article is to explore the current theories on the etiology of MRONJ and to emphasize the importance of infection in the development of this devastating pathology.

Original publication

DOI

10.1177/0022034515572021

Type

Journal article

Journal

Journal of dental research

Publication Date

04/2015

Volume

94

Pages

534 - 539

Addresses

Department of Oral and Maxillofacial Surgery, John Radcliffe Hospital, Oxford, UK.

Keywords

Humans, Biofilms, Bone Remodeling, Bone Density Conservation Agents, RANK Ligand, Host-Pathogen Interactions, Antibodies, Monoclonal, Humanized, Bisphosphonate-Associated Osteonecrosis of the Jaw