dental disorders
Postextraction Problems
Osteonecrosis of the jaw (ONJ)
 Medication-Related Osteonecrosis of the Jaw (MRONJ) is an oral lesion involving persistent exposure of mandibular or maxillary bone, which usually manifests with pain, loosening of teeth, and purulent discharge ( (MRONJ) refers to the association discovered between use of antiresorptive agents and ONJ. These agents include bisphosphonates, osteoclast-inhibiting drugs, and cathepsin K inhibitors. Cancer patients receiving IV bisphosphonates have a 4-fold increased risk of ONJ, perhaps due to greater bioavailability of IV bisphosphonates ( References ). However, oral bisphosphonate therapy for noncancer patients seems to pose very low risk of ONJ; the prevalence in this population is about 0.1% according to a recent estimate. Stopping oral bisphosphonate therapy is unlikely to reduce this already low rate of ONJ, and maintaining good oral hygiene is a more effective preventive measure than stopping oral bisphosphonates before dental procedures. Higher doses and longer duration (therapy Management of osteonecrosis of the jaw is challenging and typically involves palliation, limited debridement, antibiotics, and oral rinses. 