RT Journal Article SR Electronic A1 Hauer, Lukas A1 Jambura, Jan A1 Hrusak, Daniel A1 Chalupova, Miroslava A1 Posta, Petr A1 Rusnak, Stepan A1 Vyskocil, Vaclav T1 Surgical therapy for medication-related osteonecrosis of the jaw in osteoporotic patients treated with antiresorptive agents JF Biomedical papers YR 2020 VO 164 IS 1 SP 100 OP 107 DO 10.5507/bp.2018.081 UL https://biomed.papers.upol.cz/artkey/bio-202001-0012.php AB Background: Medication - related osteonecrosis of the jaw (MRONJ) is a rare but serious complication of antiresorptive and/or antiangiogenic therapy. It mainly affects oncological patients, however, it can occur in patients with metabolic bone diseases, although this is less frequent. These lesions not only significantly impair the quality of life but can also have impact on the treatment of any underlying disease. In some rare cases MRONJ can be life-threatening. There is still no ideal consensus for treatment, though surgical therapy has been mostly preferred in recent years. Materials and Methods: A monocentric retrospective evaluation of surgical therapy of MRONJ in osteoporotic patients, treated in the time period 3/2014-3/2018 using the uniform department-specific protocol. Results: 26 osteoporotic patients with 32 MRONJ lesions of stage 1 (9%), stage 2 (75%) and stage 3 (16%) were treated surgically. The maxilla: mandibula ratio was 1:2.2, in 19% of patients there was multiple jaw involvement. 69.2% of patients had received bisphosphonates, 15.4% denosumab and 15.4% had a history of both types of antiresorptive treatment. Complete healing was observed in all patients, in 9% of cases by secondary intention in the mean period of 6 weeks. The mean follow-up was 20.5 months. Conclusion: The presented protocol for surgical therapy was effective in the management of all MRONJ stages in the osteoporotic patients described here. The surgery is indicated as an early treatment to prevent complications and the progression of the lesions. It leads to improvement in quality of life and option to resume antiresorptive therapy if interrupted.