MRONJ: A Short Guide
Updated: Jul 12, 2021
This is the first post in a short series of posts where I summarise key ideas from a bunch of articles I read for my PS and MMIs. Reading articles can really be a slog and it is this type of post that I wish I had; the type of post that summarises only the important ideas that I can easily bring up in my MMI interviews and write about in my PS.
What is MRONJ?
MRONJ or Medication-induced osteonecrosis of the jaw is a disease that results from the taking of certain medication. Often, the medication includes drugs that prevent skeletal related events with cancer and bone metastases ( like antiresorptive and antiangiogenic drugs [reducing resorption of bone and the growth of new blood vessels]).
Necrosis is the killing and death of cells (note the distinction between apoptosis-where cells commit suicide) and the prefix osteo- is related to bones. So MRONJ is the death bone cells caused by the drugs mentioned above, usually in the maxillofacial (jaw and face) area.
An interesting articles I read was on how dental implants could increase the risk of developing MRONJ and that MRONJ is often initiated by dental extraction- this could be something to look into.
When reading about MRONJ, it will become apparent that we don't completely know all its ins and outs, mainly due to the lack of large scale clinical trials. Therefore, there is no agreed upon, optimal treatment.
Because of its complexity, MRONJ requires a multidisciplinary team to treat and as usual, eliminating risk factors and preventing the disease is key. Risk factors include underlying diseases, genetics, tobacco, age, implants and oral surgery. Since MRONJ is caused by drugs, another way to help treat it is to go on 'drug holidays'. Similarly, MRONJ emphasises the importance of having regular visits to dentists as early detection will increase the chances of treatment.