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Minyu Liu

Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia

Zhukova N.A.

Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia

Tarasenko S.V.

Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia

Litvinova D.Yu.

Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia

Risk factors for medication-related osteonecrosis of the jaw in patients receiving bisphosphonates and/or denosumab: a systematic review of the literature

Authors:

Minyu Liu, Zhukova N.A., Tarasenko S.V., Litvinova D.Yu.

More about the authors

Journal: Russian Journal of Stomatology. 2026;19(2): 56‑62

DOI: 10.17116/rosstomat20261902156

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RISK FACTORS FOR MEDICATION-RELATED OSTEONECROSIS OF THE JAW IN PATIENTS RECEIVING BISPHOSPHONATES AND/OR DENOSUMAB: A SYSTEMATIC REVIEW OF THE LITERATURE
RISK FACTORS FOR MEDICATION-RELATED OSTEONECROSIS OF THE JAW IN PATIENTS RECEIVING BISPHOSPHONATES AND/OR DENOSUMAB: A SYSTEMATIC REVIEW OF THE LITERATURE

To cite this article:

Minyu Liu, Zhukova NA, Tarasenko SV, Litvinova DYu. Risk factors for medication-related osteonecrosis of the jaw in patients receiving bisphosphonates and/or denosumab: a systematic review of the literature. Russian Journal of Stomatology. 2026;19(2):56‑62. (In Russ.)
https://doi.org/10.17116/rosstomat20261902156

Подписка 2026 Российская стоматология (Russian Journal of Stomatology)
МСФ на ЯМ
Использование инфографики авторами научных работ
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Abstract:

BACKGROUND

Medication-related osteonecrosis of the jaw (MRONJ) remains a rare but clinically relevant complication of antiresorptive treatment. Its risk is shaped by the interaction of drug exposure, oral inflammatory burden, and systemic comorbidity.

OBJECTIVE

To synthesize evidence on risk factors for MRONJ in patients receiving bisphosphonates and/or denosumab and to derive a practice-oriented prevention algorithm.

MATERIAL AND METHODS

A PRISMA 2020-oriented systematic review was conducted in PubMed/MEDLINE, Scopus, Web of Science, and eLIBRARY.ru, supplemented by CyberLeninka and hand-searching of reference lists. Guidelines, systematic reviews/meta-analyses, cohort studies, and case-control studies focused on adult patients receiving bisphosphonates and/or denosumab were eligible. Thirty-seven records, including 17 Russian VAK-indexed publications, were included in the qualitative synthesis.

RESULTS

The most consistent risk factors were oncology-dose exposure, parenteral high-dose regimens, treatment duration and cumulative exposure, sequential antiresorptive/antiangiogenic therapy, active oral inflammatory disease, tooth extraction and other invasive dental procedures, as well as diabetes, smoking, anemia, and long-term corticosteroid use. Evidence on age, sex, vascular factors, and individual laboratory markers remains heterogeneous.

CONCLUSION

MRONJ risk is multifactorial. The most applicable preventive measures are pre-treatment dental optimization, risk stratification by indication and drug class, scheduled monitoring, and a standardized management algorithm for invasive dental care.

Keywords:

medication-related osteonecrosis of the jaws
MRONJ
bisphosphonates
denosumab
antiresorptive therapy
risk factors
systematic review
PRISMA 2020
periodontitis
tooth extraction
prevention

Authors:

Minyu Liu

Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia

Zhukova N.A.

Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia

Tarasenko S.V.

Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia

Litvinova D.Yu.

Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia

Received:

09.02.2026

Accepted:

09.04.2026

Close metadata

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