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Conventional treatment modalities often yield suboptimal outcomes, with recurrence and procedural morbidity. In recent years, biomaterial-based strategies have emerged as promising alternatives by targeting MRONJ\u2019s complex pathophysiology, including imbalances in bone remodeling, impaired angiogenesis, immune dysregulation, and infection. This review highlights advances in functional biomaterials for bisphosphonate sequestration, restoration of osteo-angiogenic homeostasis, and immune modulation. These platforms have shown efficacy in promoting tissue regeneration while reducing systemic toxicity. However, clinical translation is limited by biosafety, scalability, and regulatory hurdles, such as instability in the oral environment and mismatched scaffold degradation rates. Future efforts should prioritize multifunctional, intelligent, and patient-specific biomaterials, alongside the establishment of standardized preclinical models and clinical trials. Combinatory strategies have great potential for synergistic treatment and addressing the multiple pathological factors of MRONJ.\u00a0By integrating materials engineering with mechanistic understanding, this review synthesizes current evidence to highlight the transformative potential of biomaterials for MRONJ prevention and therapy.<\/jats:p>","DOI":"10.1515\/biol-2025-1346","type":"journal-article","created":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T09:59:42Z","timestamp":1785232782000},"source":"Crossref","is-referenced-by-count":0,"title":["Advanced biomaterial-based approaches for medication-related osteonecrosis of the jaw"],"prefix":"10.1515","volume":"21","author":[{"given":"Rui","family":"Huang","sequence":"first","affiliation":[{"name":"State Key Laboratory of Oral Diseases , National Center for Stomatology, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University , Chengdu , Sichuan , 610041 , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-3256-3014","authenticated-orcid":false,"given":"Shiyu","family":"Jia","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Oral Diseases , National Center for Stomatology, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University , Chengdu , Sichuan , 610041 , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Yin","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Oral Diseases , National Center for Stomatology, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University , Chengdu , Sichuan , 610041 , China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2026,7,29]]},"reference":[{"key":"2026072809593490482_j_biol-2025-1346_ref_001","doi-asserted-by":"crossref","unstructured":"Marx, RE. Pamidronate (Aredia) and zoledronate (Zometa) induced avascular necrosis of the jaws: a growing epidemic. J\u00a0Oral Maxillofac Surg 2003;61:1115\u201317. https:\/\/doi.org\/10.1016\/s0278-2391(03)00720-1.","DOI":"10.1016\/S0278-2391(03)00720-1"},{"key":"2026072809593490482_j_biol-2025-1346_ref_002","doi-asserted-by":"crossref","unstructured":"Kawahara, M, Kuroshima, S, Sawase, T. Clinical considerations for medication-related osteonecrosis of the jaw: a comprehensive literature review. Int. J.\u00a0Implant Dent. 2021;7:47. https:\/\/doi.org\/10.1186\/s40729-021-00323-0.","DOI":"10.1186\/s40729-021-00323-0"},{"key":"2026072809593490482_j_biol-2025-1346_ref_003","doi-asserted-by":"crossref","unstructured":"Ruggiero, SL, Dodson, TB, Aghaloo, T, Carlson, ER, Ward, BB, Kademani, D. American Association of oral and maxillofacial surgeons\u2019 position paper on medication-related osteonecrosis of the Jaws-2022 update. J\u00a0Oral Maxillofac Surg 2022;80:920\u201343. https:\/\/doi.org\/10.1016\/j.joms.2022.02.008.","DOI":"10.1016\/j.joms.2022.02.008"},{"key":"2026072809593490482_j_biol-2025-1346_ref_004","doi-asserted-by":"crossref","unstructured":"Kanwar, N, Bakr, MM, Meer, M, Siddiqi, A. Emerging therapies with potential risks of medicine-related osteonecrosis of the jaw: a review of the literature. Br Dent J 2020;228:886\u201392. https:\/\/doi.org\/10.1038\/s41415-020-1642-3.","DOI":"10.1038\/s41415-020-1642-3"},{"key":"2026072809593490482_j_biol-2025-1346_ref_005","doi-asserted-by":"crossref","unstructured":"Vanpoecke, J, Verstraete, L, Smeets, M, Ferri, J, Nicot, R, Politis, C. Medication-related osteonecrosis of the jaw (MRONJ) stage III: conservative and conservative surgical approaches versus an aggressive surgical intervention: a systematic review. J\u00a0Craniomaxillofac Surg 2020;48:435\u201343. https:\/\/doi.org\/10.1016\/j.jcms.2020.02.017.","DOI":"10.1016\/j.jcms.2020.02.017"},{"key":"2026072809593490482_j_biol-2025-1346_ref_006","doi-asserted-by":"crossref","unstructured":"Kishimoto, H, Noguchi, K, Takaoka, K. Novel insight into the management of bisphosphonate-related osteonecrosis of the jaw (BRONJ). Jpn Dent Sci Rev 2019;55:95\u2013102. https:\/\/doi.org\/10.1016\/j.jdsr.2018.09.002.","DOI":"10.1016\/j.jdsr.2018.09.002"},{"key":"2026072809593490482_j_biol-2025-1346_ref_007","doi-asserted-by":"crossref","unstructured":"Miller, K, Steger, GG, Niepel, D, L\u00fcftner, D. Harnessing the potential of therapeutic agents to safeguard bone health in prostate cancer. 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