Available online 3 November 2025

Antiresorptive drugs such as bisphosphonates and denosumab are vital medications in the therapy of osteoporosis and in the treatment of cancer with osseous metastases. A rare but clinically relevant adverse effect is medication-related osteonecrosis of the jaw (MRONJ). This review outlines epidemiology, clinical features, diagnosis, treatment, and prevention of MRONJ. In addition, antiresorptives show promise in rare bone diseases relevant to oral and maxillofacial surgery, such as aneurysmal bone cysts, central giant cell granuloma, and diffuse sclerosing osteomyelitis. While early evidence indicates therapeutic benefit, further studies are needed to define safety and standardized protocols. Preventive dental care, patient education, and close interdisciplinary collaboration remain essential for optimal outcomes.

© 2025 The Authors. Published by Elsevier Ltd on behalf of European Association for Cranio-Maxillo-Facial Surgery.