Clinical outcomes of using demineralized dentin matrix bone grafts and HA-coated implants in medication-related osteonecrosis of the jaw

Bisphosphonates and denosumab are key osteoclast inhibitors used in osteoporosis treatments. While effective, these drugs can cause medication-related osteonecrosis of the jaw (MRONJ). Biofluorescence-imaging systems (BIS) were recently suggested to distinguish between pathologic and healthy bone during MRONJ surgery. This case report demonstrated a 79-year-old female with a ten-year history of bisphosphonate-developed MRONJ post-tooth extraction. BIS-guided surgery was performed, combined with hydroxyapatite (HA)-coated implants and a demineralized dentin matrix (DDM) graft. Follow-up at six months showed successful osseointegration and gingival healing without the recurrence of MRONJ or bone exposure. In conclusion, BIS is valuable for identifying pathologic bone in MRONJ surgery. The HA-coated implants and DDM have the potential for excellent tissue regeneration in MRONJ defects. (JOURNAL OF DENTAL IMPLANT RESEARCH 2024;43(4):61-66)