{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T12:26:29Z","timestamp":1792499189924,"version":"4.5.0"},"reference-count":47,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,4,26]],"date-time":"2022-04-26T00:00:00Z","timestamp":1650931200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oral. Health"],"abstract":"<jats:p>Medication-Related Osteonecrosis of the Jaw (MRONJ) was first reported in 2003. Despite the progress in the understanding of this oral complication in cancer patients for the past 18 years, there is still discussion about the best way to define MRONJ, prevent the complication, how to diagnose, and the options of treatment available. The initial reports associated MRONJ to bisphosphonates and denosumab, medications that work as bone-modifying agents. Later, other agents such as the antiangiogenics, have also been reported to cause the oral complication, either alone or in combination with antiresorptives. Initially, these medications were prescribed to patients with osteoporosis and cancers patients with bone metastasis. Today, because of the effect of the medications in the bone remodeling system, patients with several other diseases such as giant cell tumors, rheumatoid arthritis, Paget's disease of bone, fibrous dysplasia, osteogenesis imperfecta, are managed with these medications, significantly increasing the population of individuals at risk for developing MRONJ. This mini review focused on the cancer patient. It updates the dental clinician on the recent scientific literature about MRONJ and provides information on how to diagnose and manage patients being treated with these medications, suggests protocols to prevent the development of MRONJ, and present ways to manage those patients who develop the oral complication.<\/jats:p>","DOI":"10.3389\/froh.2022.866871","type":"journal-article","created":{"date-parts":[[2022,4,26]],"date-time":"2022-04-26T07:37:35Z","timestamp":1650958655000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":19,"title":["Oral Complications in Cancer Patients\u2013Medication-Related Osteonecrosis of the Jaw (MRONJ)"],"prefix":"10.3389","volume":"3","author":[{"given":"Cesar Augusto","family":"Migliorati","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,4,26]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"4253","DOI":"10.1200\/JCO.2003.99.132","article-title":"Bisphosphanates and oral cavity avascular bone necrosis","volume":"21","author":"Migliorati","year":"2003","journal-title":"J Clin Oncol."},{"key":"B2","doi-asserted-by":"publisher","first-page":"1115","DOI":"10.1016\/S0278-2391(03)00720-1","article-title":"Pamidronate (Aredia) and zoledronate (Zometa) induced avascular necrosis of the jaws: a growing epidemic","volume":"61","author":"Marx","year":"2003","journal-title":"J Oral Maxillofac Surg."},{"key":"B3","doi-asserted-by":"publisher","first-page":"527","DOI":"10.1016\/j.joms.2004.02.004","article-title":"Osteonecrosis of the jaws associated with the use of bisphosphonates: a review of 63 cases","volume":"62","author":"Ruggiero","year":"2004","journal-title":"J Oral Maxillofac Surg."},{"key":"B4","doi-asserted-by":"publisher","first-page":"1938","DOI":"10.1016\/j.joms.2014.04.031","article-title":"American Association of Oral and Maxillofacial Surgeons position paper on medication-related osteonecrosis of the jaw\u22122014 update","volume":"72","author":"Ruggiero","year":"2014","journal-title":"J Oral Maxillofac Surg."},{"key":"B5","doi-asserted-by":"publisher","first-page":"2270","DOI":"10.1200\/JCO.19.01186","article-title":"Medication-Related Osteonecrosis of the Jaw: MASCC\/ISOO\/ASCO Clinical Practice Guideline","volume":"37","author":"Yarom","year":"2019","journal-title":"J Clin Oncol."},{"key":"B6","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1002\/jbmr.2405","article-title":"Diagnosis and management of osteonecrosis of the jaw: a systematic review and international consensus","volume":"30","author":"Khan","year":"2015","journal-title":"J Bone Miner Res."},{"key":"B7","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1016\/j.jocd.2016.09.005","article-title":"Case-Based Review of Osteonecrosis of the Jaw (ONJ) and Application of the International Recommendations for Management From the International Task Force on ONJ","volume":"20","author":"Khan","year":"2017","journal-title":"J Clin Densitom."},{"key":"B8","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1016\/j.bjoms.2014.09.001","article-title":"Up to a quarter of patients with osteonecrosis of the jaw associated with antiresorptive agents remain undiagnosed","volume":"53","author":"Fedele","year":"2015","journal-title":"Br J Oral Maxillofac Surg."},{"key":"B9","doi-asserted-by":"publisher","first-page":"603","DOI":"10.1016\/j.bjoms.2014.04.009","article-title":"Staging of osteonecrosis of the jaw requires computed tomography for accurate definition of the extent of bony disease","volume":"52","author":"Bedogni","year":"2014","journal-title":"Br J Oral Maxillofac Surg."},{"key":"B10","doi-asserted-by":"publisher","first-page":"2390","DOI":"10.3390\/jcm10112390","article-title":"A Comparison of the Clinical and Radiological Extent of Denosumab [Xgeva(\u00ae)] Related Osteonecrosis of the Jaw: A Retrospective Study","volume":"10","author":"Assili","year":"2021","journal-title":"J Clin Med"},{"key":"B11","doi-asserted-by":"publisher","first-page":"312","DOI":"10.1111\/odi.13534","article-title":"Osteomyelitis, osteoradionecrosis, or medication-related osteonecrosis of the jaws? 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