Risk factors for the occurrence of medication-related osteonecrosis of the jaw

Introduction Medication-related osteonecrosis of the jaw (MRONJ) represents a new pathological entity that appears as a side effect of medications used in various diseases disrupting the normal homeostasis of bone tissue. This type of osteonecrosis occurs as consequence of antiresorptive drugs, primarily from the bisphosphonate group, but also other drugs that have a different mechanism of action on bone tissue. Aim was to point out the factors leading to the development of MRONJ. Results: There are many systemic factors, primarily endocrine and hormonal disorders, as well as the body's immunodeficiency. Risk factors for the development of MRONJ are interventions that involve the bone tissue of the jaws, primarily tooth extraction, implant procedures, curettage of the periodontal pocket, periapical operations, etc. Prevention from MRONJ is carried out with a multidisciplinary approach that involves the cooperation of rheumatologists, oncologists and dentists. Coordinately applied multidisciplinary premedication treatment reduces the incidence of MRONJ by 77.3%. Depending on the stage of development of MRONJ, there are conservative and surgical methods of treatment, which must be performed in a timely manner, because the progression of the lesion leads to significant consequences for the patient's health and life. Conclusion: Osteonecrosis of the jaw associated with the use of medicaments can be an asymptomatic, indeterminate lesion that is very difficult to diagnose, but without proper diagnosis and therapy it can develop and turn into a more severe form, complicated for treatment, with a pathological fracture of the jaw, mucocutaneous fistulas and large scars and mutilation. Prevention and multidisciplinary pretreatment and treatment are of key importance for reducing the occurrence and progression of this lesion.