Identified Medications Causing Medication-Related Osteonecrosis of the Jaw: A Literature Review

TL;DR

This review summarizes medications linked to jaw bone death, highlighting new drug classes beyond traditional ones to improve patient care.

Contribution

The study expands the understanding of MRONJ by including newer drug classes beyond antiresorptives and antiangiogenics.

Findings

MRONJ is associated with antiresorptive and antiangiogenic drugs.

Recent evidence links targeted cancer therapies and immunomodulatory agents to MRONJ.

The review emphasizes the importance of risk assessment and multidisciplinary management for MRONJ.

Abstract

Medication-related osteonecrosis of the jaw (MRONJ) is a serious adverse event that occurs in patients treated with certain medications, leading to a major side effect that can result in substantial morbidity. MRONJ is known to be associated with antiresorptive (AR) and antiangiogenic (AA) medicines, but recent evidence suggests that other medications may also be involved. Recognizing a broad range of drug-induced risk factors is important, notably in light of the increasing number of drugs associated with MRONJ. The primary objective of this review is to update and synthesize findings from the past 22 years (2003 to April 2025) regarding medications associated with MRONJ, expanding beyond the traditional AR and AA drugs to include more recent and developing therapeutic classes. This review combines findings from recent literature, including studies on AR and AA medications, as well as other drug classes, such as targeted cancer therapies and immunomodulatory agents. This review provides updated insights into MRONJ for healthcare practitioners and dentists, emphasizing the significance of risk assessment, early recognition, and multidisciplinary management to improve patient care and outcomes. Given its potential to cause significant morbidity and complicate dental and medical treatments, MRONJ presents a critical concern in clinical practice, underscoring the need for heightened awareness among healthcare professionals.

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