Although there are numerous reports on surgical treatment of medication-related osteonecrosis of the jaw （MRONJ）, the effectiveness of surgical treatment at an early stage has recently been reported.
Here, we report a case of MRONJ in a female patient in her 60s who was successfully managed by surgical treatment with a titanium plate. She was referred to our hospital due to jaw pain while eating. She had been receiving bisphosphonate therapy for osteoporosis and conservative therapy for MRONJ, but her symptoms did not improve and the bone exposure progressed, increasing the risk of pathological fractures of the jaw. We diagnosed her with MRONJ stage 2 and resected the necrotic bone under general anesthesia. We used a titanium plate to reduce the risk of pathological fractures, and applied a polyglycolic acid sheet and fibrin glue spray on the bone surface after resection. The wound was completely coated by a mucous membrane after 11 days. For 24 months after the operation, the patient exhibited no clinical or radiographic evidence of recurrence. The patient wears a full set of upper and lower dentures, and maintains good mastication.