Nisi M, Izzetti R, Gennai S, Bellini P, Graziani F, Gabriele M. Surgical management of medication-related osteonecrosis of the jaw patients related to dental implants. J Craniofac Surg 2020; DOI: 10.1097/SCS.0000000000006283. [Epub ahead of print].

Surgical treatment seems to have a positive impact on MRONJ treatment also in cases of peri-implant involvement. Monitoring and prevention are fundamental in patients under pharmacological treatment with anti-resorptive/antiangiogenic drugs.

This case series reported on patients with peri-implant medication-related osteonecrosis of the jaw (MRONJ) and described the onset of the condition and the treatment outcome. Fifteen consecutive patients with clinical diagnosis of peri-implant MRONJ were retrospectively included. The sample was stratified on the base of oral, pharmacological, and general health variables. The number of affected implants was recorded and MRONJ staging applied. Surgical treatment was performed with a standardised operative protocol, involving implant removal, sequestrectomy, debridement of soft tissue, and bone curettage. Follow-up evaluating surgical outcome was performed at 12 months after surgery. All MRONJ lesions were symptomatic, and in six patients bone exposure was detected. Forty implants were evaluated, with MRONJ being present around 29 implants. Twelve patients were diagnosed with Stage III MRONJ, and three patients with Stage II MRONJ. Surgical treatment lead to complete healing in 87% of cases, with 100% success for maxillary MRONJ.