Medication-Related Osteonecrosis Of The Jaw (Mronj): Current Classification And Radiological Findings
Özet
Medication-Related Osteonecrosis of the Jaw (MRONJ) is a serious jaw bone disease with a multifactorial etiology, associated with the use of various pharmacological agents, primarily antiresorptive and antiangiogenic drugs. Currently, in addition to bisphosphonates and denosumab, antiangiogenic drugs, immunomodulators, and certain targeted therapies have also been associated with the development of MRONJ. In this chapter, the current diagnostic criteria, classification, and staging system of MRONJ are summarized in accordance with international guidelines, and the drug-related, local, systemic, and genetic risk factors involved in the development of the disease are evaluated in light of current literature. In addition, the diagnostic contributions of imaging modalities—including panoramic radiography, cone-beam computed tomography, computed tomography, magnetic resonance imaging, ultrasonography, single-photon emission computed tomography (SPECT), and positron emission tomography (PET)—to early diagnosis, staging, determination of lesion extent, and treatment planning are addressed. Furthermore, the role of current surgical approaches, such as fluorescence-guided bone resection, in distinguishing between necrotic and vital bone tissue is discussed. In conclusion, evaluating clinical findings together with advanced imaging methods is of great importance for the effective management of MRONJ, in terms of early diagnosis, appropriate treatment planning, and improved surgical success.
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