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Background Breast cancer is one of the most common cancers among women, with improved therapies reducing mortality. Antiresorptive (AR) therapy is crucial for managing bone loss and skeletal complications in patients with cancer. However, high-dose AR therapy may carry a significant risk of medication-related osteonecrosis of the jaw (MRONJ). This study aimed to investigate the incidence of MRONJ and its risk factors in patients with diagnosed breast cancer undergoing either biannual postoperative bisphosphonate therapy or high-dose AR therapy. Methods This study followed 220 female patients receiving AR therapy in Sweden, from 2015 to 2020. Oral health status was assessed before and during AR therapy, collecting data on MRONJ incidence, dental procedures, and data on breast cancer characteristics. Statistical analyses included Fisher’s exact tests, and group differences in Kaplan-Meier curves were assessed using the log-rank test. p < 0.05 was considered statistically significant. Results The cohort comprised 119 patients on biannual AR therapy and 101 patients on high-dose AR therapy. Nine patients (4.0%) developed bone metastases and transitioned to high-dose AR therapy after a mean interval of 237 days; of these, 55.5% subsequently switched from bisphosphonates to denosumab. MRONJ cumulative incidence was 5.5% in the overall cohort and 11.9% in the high-dose group (p < 0.001); no MRONJ cases occurred in the biannual group. Tooth extractions (30.5%, p < 0.001), localisation to the mandible (83.3%, p = 0.039) and number of AR doses (p = 0.004) were significantly associated with the development of MRONJ. Notably, spontaneous MRONJ accounted for 41.7% of cases. Baseline DMFT did not differ, but MRONJ patients had a higher DMFT increment during follow-up. Conclusions This study identifies a significant association between high-dose AR therapy and the development of MRONJ in breast cancer patients, with tooth extractions, mandibular localisation, and cumulative AR exposure identified as risk factors. MRONJ was not observed in the biannual AR therapy group. These findings underscore the importance of comprehensive dental assessments and early risk stratification.

CT images taken before patients begin treatment with bone resorption inhibitors may contain measurable clues about who will later develop medication-related osteonecrosis of the jaw (MRONJ), according to a retrospective study by a researcher at Hiroshima University.

TARIFAS Jornada Universitaria SECIB-SEMO-SELO: Gratuita para los inscritos al Simposio (es necesario apuntarse al inscribirse)

A new large-scale study published in the American Journal of Dentistry found that patients with medication-related osteonecrosis of the jaw face an increased risk of acute periapical abscesses...

Story at-a-glance Medication-related osteonecrosis of the jaw (MRONJ) is a serious condition where jawbone dies and fails to heal, and it’s been linked to common bone drugs like bisphosphonates and denosumab A Finnish study found that people taking denosumab were five times more likely to develop MRONJ than those using bisphosphonates, with cancer patients and long-term users at highest risk Adding corticosteroids to bone drugs significantly worsened outcomes, multiplying the risk of jaw disease by up to six times in some users MRONJ often begins after dental procedures like extractions, but it also develops in people with gum disease or dentures — even without dental intervention Preventive dental care, a nutrient-rich diet, and lifestyle habits that support natural bone repair offer your best defense against this disfiguring and painful condition

Leading €8.6M EU project to treat cancer jaw disease with food waste

A recent study reveals that post-surgical recovery for patients with MRONJ is largely determined by disease stage rather than the medication type used. Insights reveal critical recovery factors.

New research shows postoperative outcomes also were closely tied to why the medication was originally prescribed. ROSEMONT, Ill., June 4, 2026 /PRNewswire/ -- Recovery after jaw surgery for a serious condition called medication-related osteonecrosis of the jaw (MRONJ) depends more on the...