Journal of the Korean Association of Oral and Maxillofacial Surgeons
- P-ISSN2234-7550
- E-ISSN2234-5930
- SCOPUS, KCI, ESCI
ISSN : 2234-7550
Article Contents
- 2026 (Vol.52)
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- 2023 (Vol.49)
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- 2002 (Vol.28)
Medication-related osteonecrosis of the jaw: an evidence-based 2025 position statement from a Korean multidisciplinary task force
Kong Sung-Hye (Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea)
Kim Jae-Young (Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, Korea)
Kwak Mi Kyung (Division of Endocrinology and Metabolism, Department of Internal Medicine, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Korea)
Kim Jun-Young (Department of Oral and Maxillofacial Surgery, Yonsei University College of Dentistry, Seoul, Korea)
Oh Ji-Hyeon (Department of Oral and MaxilloFacial Surgery, Dental Hospital, Gangneung-Wonju National University, Gangneung, Korea)
Park Hyung-Youl (Department of Orthopedic Surgery, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea)
Kim BeomTaek (Department of Family Practice and Community Health, Ajou University School of Medicine and Graduate School of Medicine, Suwon, Korea)
Lee Young-Kyun (Department of Orthopedic Surgery, Seoul National University Bundang Hospital, Seongnam, Korea.)
Han Jeong Joon (Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea)
Kim Moon-Young (Department of Oral and Maxillofacial Surgery, College of Dentistry, Dankook University, Cheonan, Korea)
Choi Yong Jun (Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Korea)
Kwon Yong-Dae (Department of Oral and Maxillofacial Surgery, Kyung Hee University College of Dentistry, Seoul, Korea)
Song Kwang-Sup (Department of Orthopaedic Surgery, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea)
Kim Beom-Jun (Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea)
Kim Sun-Jong (Department of Oral and Maxillofacial Surgery, Ewha Womans University College of Medicine, Seoul, Korea)
Baek Seung-Hoon (Department of Orthopedic Surgery, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Korea)
Lee Dong Ock (Center for Uterine Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea)
Choi Han Seok (Division of Endocrinology and Metabolism, Department of Internal Medicine, Dongguk University Ilsan Hospital, Goyang, Korea)
Kim Ha Young (Division of Endocrinology, Department of Internal Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea)
Kwon Tae-Geon (Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyungpook National University, Daegu, Korea)
Abstract
With a rapidly aging population and increasing use of antiresorptive agents, medication-related osteonecrosis of the jaw (MRONJ) represents a growing clinical challenge worldwide. To address the need for tailored clinical guidance, a multidisciplinary task force was convened. Five Korean academic societies—the Korean Society for Bone and Mineral Research, the Korean Association of Oral and Maxillofacial Surgeons, the Korean Association of Maxillofacial Plastic and Reconstructive Surgeons, the Korean Society of Osteoporosis, and the Korean Endocrine Society—collaborated to develop this position statement. The consensus was formulated through comprehensive reviews of literature, combined with three rounds of formal surveys to consolidate expert opinion on controversial topics. This position paper provides evidence-based clinical guidelines for the prevention, diagnosis, and management of MRONJ tailored to the Korean healthcare environment. The diagnostic criteria affirm the standard definition but add a provision for diagnosis based on clinical or radiographic evidence of necrotic bone, even if the traditional 8-week timeframe has not been met. The committee advocates for retaining Stage 0 in the staging system to emphasize early detection and preventive intervention. Key recommendations include prescriptive, drug-specific guidelines for prophylactic drug holidays (e.g., a 2-month pause for oral bisphosphonates; timing surgery 3-4 months after the last denosumab injection) to minimize MRONJ risk from dental procedures. This statement also provides a clear framework for therapeutic drug holidays in established MRONJ, carefully balancing the need for jaw healing against systemic fracture risk. For treatment, this statement advocates for early and active surgical intervention across all MRONJ stages, supported by evidence of superior long-term outcomes compared to conservative management. This position statement offers a unique, evidence-based Korean clinical practice guideline for managing MRONJ. It is intended to standardize care, reduce clinical confusion, and ultimately improve patient outcomes by providing a clear framework for decision-making.
- keywords
- Medication-related osteonecrosis of the jaw, Bisphosphonates, Denosumab, Osteoporosis, Drug holiday, Guideline, Prevention
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