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Date of Award
Spring 2025
Degree Name
Master of Medical Science (Physician Assistant)
Department
Physician Assistant; College of Health Sciences
First Advisor
Alexia Arhontakis
Abstract
MRONJ (medication-related osteonecrosis of the
jaw) is a condition that results in bone death
within the jaw, most commonly the mandible in
patients who are or have taken bisphosphonate or
other antiresorptive drugs. There is a need to be
equipped to educate patients on the topic of
bisphosphonates and the side effects, including
MRONJ, within numerous medical specialties
including family medicine/general practice,
gynecology/women’s health, oncology,
rheumatology, orthopedics, and more. With older
mean populations, providers can expect to see an
increase in patients who are both on and asking
about the medication class. With numerous
articles resulting from research on the class and its
side effects, patients have been coming in with
concerns and weariness over the drugs partially at
the direction of other healthcare providers.
Bisphosphonates have been prescribed to prevent
pathologic fractures resulting from bone pathology
such as osteoporosis or metastatic bone lesions.
There have been rising concerns amongst
providers and patients surrounding this potential
side effect. This article aims to clarify the true
prevalence of MRONJ and offers risks to stratify
while appropriately selecting patients for the use
of the medication. With a greater understanding of
who is a poor candidate for bisphosphonate
therapy, there is greater prescription confidence
and medical advising to be had in a lower risk of
MRONJ in a patient that has been risk stratified.
Recommended Citation
Pressley, Jordan, "Risk stratification strategies in patient selection for the prevention of bisphosphonate-related osteonecrosis of the jaw" (2025). Capstone Showcase. 59.
https://scholarworks.arcadia.edu/showcase/2025/pa/59
Risk stratification strategies in patient selection for the prevention of bisphosphonate-related osteonecrosis of the jaw
MRONJ (medication-related osteonecrosis of the
jaw) is a condition that results in bone death
within the jaw, most commonly the mandible in
patients who are or have taken bisphosphonate or
other antiresorptive drugs. There is a need to be
equipped to educate patients on the topic of
bisphosphonates and the side effects, including
MRONJ, within numerous medical specialties
including family medicine/general practice,
gynecology/women’s health, oncology,
rheumatology, orthopedics, and more. With older
mean populations, providers can expect to see an
increase in patients who are both on and asking
about the medication class. With numerous
articles resulting from research on the class and its
side effects, patients have been coming in with
concerns and weariness over the drugs partially at
the direction of other healthcare providers.
Bisphosphonates have been prescribed to prevent
pathologic fractures resulting from bone pathology
such as osteoporosis or metastatic bone lesions.
There have been rising concerns amongst
providers and patients surrounding this potential
side effect. This article aims to clarify the true
prevalence of MRONJ and offers risks to stratify
while appropriately selecting patients for the use
of the medication. With a greater understanding of
who is a poor candidate for bisphosphonate
therapy, there is greater prescription confidence
and medical advising to be had in a lower risk of
MRONJ in a patient that has been risk stratified.