JOMS Study: MRONJ Surgery Recovery Depends on Disease Stage, Not Drug Type

New research shows postoperative outcomes also were closely tied to why the medication was originally prescribed.

ROSEMONT, Ill., June 4, 2026 /PRNewswire/ -- Recovery after jaw surgery for a serious condition called medication-related osteonecrosis of the jaw (MRONJ) depends more on the patient's underlying condition and stage of the disease than on the type of medication the patient had taken, a new study finds. The research published in the Journal of Oral and Maxillofacial Surgery (JOMS) – the peer-reviewed official journal of the American Association of Oral and Maxillofacial Surgeons (AAOMS) – provides important guidance for MRONJ patients and helps clarify what factors truly impact healing.

MRONJ is a rare side effect linked to medications used to treat osteoporosis or bone complications from cancer. It can lead to exposed bone in the jaw, infection, pain and difficulty eating or speaking. Oral and maxillofacial surgeons often treat the condition with surgery to remove damaged bone and promote healing.

Researchers followed 90 patients diagnosed with MRONJ who underwent jaw surgery at Ewha Womans University Medical Center in Seoul, South Korea, between 2008 and 2024. The study compared healing times and the need for additional operations in patients prescribed the bone-strengthening medications denosumab or zoledronate. Overall, 84 percent achieved complete healing, with most recovering within three to five months.

When researchers adjusted for patient-specific factors, however, a more nuanced picture emerged: the type of medication did not predict outcomes. Instead, recovery was more closely tied to the stage of the disease and why the medication was originally prescribed. Patients with more advanced jaw damage or those being treated for cancer-related conditions were more likely to experience slower healing or require additional procedures.

The authors noted that understanding these factors can help surgeons individualize counseling and follow-up care for their patients.

The results also align with current AAOMS MRONJ guidance, which emphasizes tailoring treatment based on disease stage. Oral and maxillofacial surgeons have the training to evaluate the extent of jaw damage and customize surgical care to enhance recovery.

Before any dental procedure, AAOMS advises patients taking bone-strengthening medications like denosumab or zoledronate to discuss their treatment history with their surgical team. Jaw pain, swelling or exposed bone in these patients warrants immediate medical attention.

The authors of "Does Drug Type Influence Surgical Outcome in MRONJ? A Comparison of Denosumab and Zoledronate" are Jung-Hyun Park, DDS, PhD; Soo Young Choi, DDS; Anna Son, MS; Shin-Won Hwang, DDS; Jin-Woo Kim, DDS, PhD; and Sun-Jong Kim, DDS, PhD.

The full article can be accessed at JOMS.org/article/S0278-2391(26)00035-2/fulltext.

About JOMS

The Journal of Oral and Maxillofacial Surgery is published by the American Association of Oral and Maxillofacial Surgeons to present to the dental and medical communities comprehensive coverage of new techniques, important developments and innovative ideas in oral and maxillofacial surgery. Practice-applicable articles help develop the methods used to handle dentoalveolar surgery, facial injuries and deformities, TMJ disorders, oral and head and neck cancer, jaw reconstruction, anesthesia and analgesia. The journal also includes specifics on new instruments and diagnostic equipment, and modern therapeutic drugs and devices.

About AAOMS
The American Association of Oral and Maxillofacial Surgeons (AAOMS) represents more than 9,000 oral and maxillofacial surgeons in the U.S. AAOMS surgeons specialize in treating diseases, injuries, and defects of the mouth, jaw and face. Learn more at AAOMS.org

Contact:
Jolene Kremer
Associate Executive Director, Communications and Publications
American Association of Oral and Maxillofacial Surgeons
847-233-4336
[email protected]
AAOMS.org

SOURCE AAOMS/Journal of Oral and Maxillofacial Surgery