Given the use of anti-resorptive and antiangiogenic drugs, medication-related osteonecrosis of the jaw (MRONJ) has gained wide attention as a severe side effect. MRONJ is a multifactorial disease with a number of risk factors. The population incidence of BRONJ is approximately 1×10-5per year. Many hypotheses are proposed to explain the mechanism. Bisphosphonates and denosumab inhibit osteoclast differentiation and function and increase apoptosis, which lead to decreased bone resorption and remodeling. Bisphosphonates reduce the blood supply to the jaw area and has immuno-suppressive effects. Oral local flora can also aggravate the damage of tissues and reduce angiogenesis. The direct effect of bisphosphonates on oral mucosa cells and the anatomy of the jaw have a role on the development of osteonecrosis. According to sickness status, treatment Methods are different but are focused on reducing pain, treating soft and hard tissue infections, and delaying or stopping the process of osteonecrosis. This article reviewed the risk factors, relevant mechanisms, and prevention and treatment strategies.
