Medication-Related Osteonecrosis of the Jaws (MRONJ): imaging assessment of risk factors

The rationale behind this project:

The use of antiresorptive medication, such as bisphosphonates and denosumab, is very common within patients with cancer and osteoporosis. This group of medications interferes with the normal resorption-apposition cycle of the bone and its effect is essential to prevent bone fractures and bone metastasis in these groups of patients, respectively. However, the use of these medications has a known side effect: Medication-Related Osteonecrosis of the Jaws (MRONJ).

MRONJ is clinically described as the exposure of necrotic bone in the oral cavity that persists for at least 8 weeks and that can be associated with fistula, infection, and pain. In contrast with the clinical manifestation, bone changes are present even before we can observe the wound and they can only be identified using x-rays or other imaging modalities. It is not yet clear which bony characteristics are considered as early radiological signs and there is contradictory evidence regarding the best treatment option. Based on this fact, this doctoral project aims to identify characteristic bone patterns of MRONJ and the local risk factors for this pathology using diagnostic imaging.

Published articles:


Early imaging signs of the use of antiresorptive medication and MRONJ: a systematic review


Moreno-Rabié C, Gaêta-Araujo H, Oliveira-Santos C, Politis C, Jacobs R. Early imaging signs of the use of antiresorptive medication and MRONJ: a systematic review. Clin Oral Investig. 2020 Sep;24(9):2973-2989. doi: 10.1007/s00784-020-03423-0. Epub 2020 Jul 6. PMID: 32627123.