University Archives

Medication-related osteonecrosis of the jaw (MRONJ) is a severe adverse effect associated with antiresorptive therapies like intravenous bisphosphonates, particularly in oncology patients. While implant placement during oncologic therapy is contraindicated, the risk posed by pre-existing, long-term osseointegrated implants remains unclear, with potential links to peri-implantitis as a trigger.​ This paper reports a 72-year-old male with metastatic prostate cancer on monthly zoledronic acid therapy presented with dental implants placed over 20 years prior the oncologic treatment. Patient complained of pain in the site of the implants and showed sign and symptoms of MRONJ stage 2. Surgical intervention involved implant removal, sequestrectomy, debridement and tension-free closure; followed by antibiotic therapy and improvements of oral hygiene. Five-year follow-up revealed no recurrence, intact neurosensory function, and normalized bone trabeculation.​ Pre-existing dental implants may contribute to MRONJ development in patients on intravenous bisphosphonates, potentially via peri-implant pathology. Prompt surgical management yields favorable long-term outcomes, emphasizing multidisciplinary monitoring in high-risk cases.