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Etiopathogenesis of medication-related osteonecrosis of the jaws: a review

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Abstract

This study compiles the main hypotheses involved in the etiopathogenesis of medication-related osteonecrosis of the jaw (MRONJ). A narrative review of the literature was performed. The etiopathogenesis of MRONJ is multifactorial and not fully understood. The main hypothesis considers the disturbance of bone turnover caused by anti-resorptive drugs. Bisphosphonates and denosumab inhibit osteoclast activity through different action mechanisms, accumulating bone microfracture. Other hypotheses also consider oral infection and inflammation, the antiangiogenic effect and soft tissue toxicity of bisphosphonates, and the inhibition of lymphangiogenesis. Knowledge of the current theories for MRONJ is necessary to define future studies and protocols to minimize the incidence of this severe condition.

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Authors and Affiliations

  1. Postgraduate Program in Dental Sciences, Federal University of Santa Maria, Santa Maria, RS, Brazil

    Gabriel Bassan Marinho Maciel

  2. Department of Pathology, Federal University of Santa Maria, Av. Roraima, 1000, Santa Maria, RS, 97015-900, Brazil

    Gabriel Bassan Marinho Maciel, Roberto Marinho Maciel, Kívia Linhares Ferrazzo & Cristiane Cademartori Danesi

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  1. Gabriel Bassan Marinho Maciel
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  2. Roberto Marinho Maciel
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All authors contributed to the study conceptualization and methodology. Material preparation and writing - original draft were performed by G.B.M.M. and R.M.M. Writing - review & editing, supervision and project administration were performed by K.L.F. and C.C.D. All authors read and approved the final manuscript.

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Bassan Marinho Maciel, G., Marinho Maciel, R., Linhares Ferrazzo, K. et al. Etiopathogenesis of medication-related osteonecrosis of the jaws: a review. J Mol Med 102, 353–364 (2024). https://doi.org/10.1007/s00109-024-02425-9

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