Medication Related Osteonecrosis of the Jaws (MRONJ), is a rare condition that presents itself as a nonhealing wound in the jaw with exposed bone. MRONJ occurs due to an impaired wound healing capacity of the jaw seen in patients who are currently taking or previously had exposure to a number of medications. Some of these medications are used as adjuncts in chemotherapy care for cancer patients (such as Xgeva®, Prolia®, Zometa®). Other medications are used in patients with osteoporosis (such as: Boniva®, Fosamax®, Actonel®). Cases of MRONJ have also been seen in patients who had exposure to Avastin®, Sirolimus®, Humira®, Methotrexate®, and Infliximab®.
Prevention of MRONJ requires a visit to your dentist prior to starting any of these medications if time permits. While on these medications, you should consult with your dentist and oral and maxillofacial surgeon if you require a surgical procedure (such as extractions or implant placement). Avoiding surgery while on these medications may be advised to prevent the possible development of MRONJ.
If MRONJ develops, you may develop sharp areas of the jaw bone that irritate your tongue or cheek. In advanced cases, you may develop pain, discomfort, infection, and jaw fractures. Treatment usually involves symptom control and methods of avoiding infection (oral hygiene measures, antibiotic mouthwashes, and antibiotics if needed). In rare situations, surgery may be indicated.