Medication-related osteonecrosis of the jaw (MRONJ) - Balancing treatments benefits and risks

Medication-related osteonecrosis of the jaw (MRONJ) is a rare adverse event of treatment with bone resorption inhibitors (BRIs), including bisphosphonates and denosumab, mostly affecting patients with bone metastatic cancer or multiple myeloma, and to a lesser extent patients with osteoporosis. Prior research has focused heavily on defining optimal treatment and prevention strategies for MRONJ. However, the implementation of these prevention strategies in routine practice has changed the epidemiology of MRONJ, with an increasing number of patients now presenting with earlier stages of MRONJ or with symptoms that are considered to represent prodromal stages of this condition. The optimal management of these patients is currently ill-defined and questions remain on the impact of prevention strategies on quality-of-life in specific subgroups of patients. This dissertation aims to fill current knowledge-gaps in the management of these patients and contribute to better balancing the benefits and risks of BRI treatment.