Medication related osteonecrosis of the jaws. Experience of a surgical treatment center

This thesis aims to illustrate the research activity carried out during the PhD course.This effort is the ending product of a series of different projects activity and research studies conducted over the past three years at the Oral Surgery Unit of the Department of Dentistry of the University of Messina.Our research group is studying the Medication-Related Osteonecrosis of the Jaws (MRONJ) with a focus on the surgical treatment of the disease and aim to develop new therapeutic strategies to overcome failures and recurrence and improve patient care.Never forgetting that a considerable part of our work is concentrated on the patient’s quality of life. Our objective is also to examine the potential culprits in the pathophysiology of MRONJ using epidemiological data contributing to the growing knowledge in the field of MRONJ prevention and treatment. The two pathways work in tandem to explore the etiological underpinnings of MRONJ and move towards transforming those findings into MRONJ treatments. Therefore we will examine the different performed studies, mainly observational, both on prevention and treatment of MRONJ because personalized care can only come from a thought understanding of individual risk factors. Introduction Early predictors of outcome reflect long-term prognosis and support clinical decision-making. While there is a risk of MRONJ with bone-modifying agents, this should be considered in relation to the bene=its of treatment on the patient's quality of life. Bearing in mind that the best therapeutic approach is identified through the integration of patient, primary physician and oral surgeon assessments and the application of a combined paradigm that allows to tailor prevention and treatment strategies for each of our MRONJ patients.