Medication-Related Osteonecrosis of the Jaw (MRONJ)

Medication-related osteonecrosis of the jaw (MRONJ) is a severe bone condition that can develop in patients who have been treated with certain medications.

Advanced MRONJ Treatment

Certain medications are prescribed to treat osteoporosis, metastatic bone cancer, and other diseases that affect bone density. While these treatments are highly effective in preventing bone loss, they can sometimes result in the development of osteonecrosis—a condition in which the bone tissue dies due to inadequate blood supply. Dr. Anastasiya Quimby provides expert care for patients dealing with MRONJ, utilizing advanced techniques to restore oral health and quality of life.

woman touching her cheek showing herself in pain

What Causes MRONJ?

MRONJ typically occurs when the natural balance between bone resorption (breakdown) and bone regeneration is disrupted by medications designed to strengthen bones or inhibit cancer-related bone metastases. These medications can reduce bone turnover, which decreases the bone’s ability to heal itself following trauma, dental extractions, or even minor injuries to the jaw. Additionally, antiangiogenic medications, which prevent the formation of new blood vessels, may further limit the bone's ability to repair itself by reducing blood flow to the area.

Who Is at Risk for MRONJ?

The following patients are at increased risk for developing medication-related osteonecrosis of the jaw:

Patients undergoing long-term treatment with bisphosphonates or denosumab, especially those receiving high doses for cancer-related conditions
Those who have experienced invasive dental procedures such as tooth extractions, dental implants, or surgery involving the jawbone
Patients with ill-fitting dentures or untreated oral infections which can increase trauma to the jawbone
Patients with poor oral hygiene, gum disease, or untreated dental issues

Symptoms of MRONJ

MRONJ can present with various symptoms, depending on the severity and progression of the condition. Some common signs include the following:

Exposed bone in the mouth that does not heal
Pain or swelling in the jaw resulting from bone tissue becoming necrotic
Infection in the surrounding soft tissues which may result in drainage, pus, and swelling
Loose teeth, which make eating or speaking difficult
Wounds in the mouth that take an unusually long time to heal

Patients who are at risk of developing MRONJ should be vigilant for these symptoms and seek immediate medical attention if they occur.

MRONJ Treatment Options

AQ Surgery is focused on preserving function, alleviating pain, and promoting healing in patients experiencing medication-related osteonecrosis of the jaw. Dr. Quimby utilizes advanced surgical techniques to carefully excise damaged tissue while preserving healthy structures. In some cases, debridement and removal of necrotic bone allow the surrounding healthy tissue to regenerate and heal. However, in more severe cases, bone grafting may be required to restore the jaw's structural integrity after removing necrotic tissue. This procedure involves transplanting healthy bone tissue from another part of the body or using synthetic bone substitutes to rebuild the affected area.

Dr. Quimby’s expertise in microvascular surgery enables her to perform complex reconstructions, where healthy tissue is transplanted from another part of the body to replace the necrotic bone and restore both function and aesthetics. Microvascular reconstruction is especially important in cases where the jawbone's integrity has been compromised, affecting the patient’s ability to eat, speak, or maintain a normal facial appearance. To further enhance healing, Dr. Quimby may incorporate regenerative techniques into treating MRONJ. Platelet-rich fibrin (PRF), mesenchymal stem cells, and exosomes promote tissue regeneration and accelerate the healing process. These therapies can improve outcomes by enhancing the body’s natural ability to repair damaged bone and soft tissue.

Why Choose AQ Surgery?

Dr. Anastasiya Quimby’s extensive expertise in oral and maxillofacial surgery, head and neck oncology, and microvascular reconstruction makes AQ Surgery the premier choice for MRONJ treatment. Dr. Quimby is a highly skilled, board-certified surgeon offering exceptional, comprehensive care for head and neck cancer patients. Her integrated approach allows her to handle even the most complex cases, from tumor removal to complete jaw and facial reconstruction, minimizing the need for multiple surgeries and specialists. Her diverse background in dental, medical, ENT, oncology, and plastic surgery allows her to provide a holistic treatment plan, promoting faster recovery and enhanced outcomes. Dr. Quimby is committed to precise diagnosis, personalized care, and improving the quality of life for her patients post-treatment. Specializing in complex cases involving facial tumors and reconstructive surgery, she ensures each patient receives expert, tailored treatment that addresses their specific needs.

Take Control of MRONJ at AQ Surgery

If you or a loved one is at risk of developing medication-related osteonecrosis of the jaw or has already been diagnosed, it’s important to seek supportive care as soon as possible. Dr. Quimby specializes in diagnosing and treating MRONJ in West Palm Beach, offering personalized treatment plans that address the underlying condition and its impact on oral health. Contact AQ Surgery today to schedule a consultation with Dr. Quimby and learn how she can help restore your health and quality of life.