Medication-related osteonecrosis of the jaw (MRONJ) is a serious complication in patients receiving antiresorptive therapies for\nbone neoplastic localizations and osteoporosis. The aim of this study was to evaluate the clinicopathological features of MRONJ\nin a cohort of patients treated by new antiresorptive drugs (denosumab) and the corresponding outcome after 13-year maximum\nfollow-up.Overall, 244 patients affected byMRONJ were treated from2003 to 2015. After clinical and radiological examinations, all\nlesions were staged according to a dimensional staging system and then surgically treated. All the denosumab-related lesions were\nclassified as stage II or III, thus requiring a more or less invasive surgical approach, despite the results of many recent studies, which\nsuggested a conservative medical approach with early resolution forMRONJ in patients on denosumab. In the current series, 86.9%\nof treated lesions showed complete clinical and radiological healing, while 13.1% recurred; all recurrences were detected in patients\nwho could not interrupt chemotherapy, steroids, and/or antiresorptive drugs administration due to their general conditions. In\nconclusion, all oral specialists should be aware of the MRONJ risk among patients taking new antiresorptive drugs; moreover, our\nprotocol based on surgical treatment guided by dimensional staging could be considered effective in view of the low recurrence\nrate.
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