SURGICAL MANAGEMENT OF MEDICATION-RELATED OSTEONECROSIS OF THE JAW (MRONJ)

Abstract

Medication-related osteonecrosis of the jaw (MRONJ) is a pathological condition with multifactorial etiology, commonly associated with the use of antiresorptive and antiangiogenic drugs. This study aimed to analyze, through an integrative literature review, the scientific evidence regarding the surgical management of MRONJ, focusing on indications, techniques, and clinical outcomes. The bibliographic search was conducted in scientific databases, including studies published between 2016 and 2025. Clinical studies, systematic reviews, and guidelines addressing surgical treatment were included. The findings demonstrated that surgical management is more effective than conservative approaches, particularly in advanced stages, and is strongly associated with complete removal of necrotic tissue. More extensive surgical techniques showed higher success rates, although the choice of procedure should be individualized. Adjunctive therapies have shown promising results but still lack standardization. Additionally, a shift in clinical guidelines toward early surgical intervention was observed. It is concluded that surgical treatment represents the main therapeutic strategy for MRONJ, and further high-level evidence studies are needed to establish standardized clinical protocols.