2024 Volume 37 Issue 4 Pages 277-286
The position paper on medication-related osteonecrosis of the jaw （MRONJ) was revised in July 2023 in Japan. It is noted that the risk factors for MRONJ are persistent infections such as periapical lesions, periodontal disease, and peri-implantitis, rather than invasive procedures such as tooth extractions and dental implant surgery compared to the previous position paper (2016). In addition, the number of MRONJ patients caused by antiresorptive agents is still increasing in Japan, and so the importance of medical-dental-pharmacological cooperation is emphasized.
It is suggested that, in principle, there should be no prophylactic withdrawal of antiresorptive agents at the time of invasive procedures such as tooth extraction. Dental implant surgery in patients taking low doses of antiresorptive agents is not necessarily contraindicated if they do not have other MRONJ risk factors (diabetes, autoimmune diseases, undergoing dialysis, etc.). However, implant-associated MRONJ is often triggered by peri-implantitis. Therefore, careful consideration is required when planning dental implant treatment, and maintenance and patient education after dental implant surgery are particularly crucial.
