Current challenges and emerging solutions in dentistry for treating medication-related osteonecrosis of the jaw (MRONJ): the state of the art in the era of personalized medicine.

OBJECTIVE: Medication-related osteonecrosis of the jaw (MRONJ) is a serious complication associated with antiresorptive, and antiangiogenic therapies commonly used to treat osteoporosis, malignant bone tumors, and metastatic diseases. This review provides a comprehensive overview of the pathophysiology, clinical presentation, diagnosis, prevention, and management of MRONJ. METHODS: This narrative review examined the prevalence of MRONJ and its clinical and radiological features, particularly those relevant to disease staging, and outlined current preventive and treatment strategies, aiming to improve patient outcomes and quality of life. RESULTS: Patients with cancer receiving high-dose intravenous antiresorptive medications exhibited a higher incidence of MRONJ than that observed in patients treated for osteoporosis. Clinical staging systems, especially those developed by the American Association of Oral and Maxillofacial Surgeons, facilitate disease classification based on clinical and imaging findings, thereby guiding treatment selection and prognosis assessment. Preventive approaches, conservative management, surgical procedures, and adjunct therapies have been proposed to promote healing of both hard and soft tissues. CONCLUSION: Although emerging therapeutic options are promising, prevention and personalized treatment remain major challenges.