Shifting Trends in Maxillofacial Infections: The Impact of MRONJ - Overview of the Literature

Konstantin Stamatov

Abstract: Maxillofacial infections encompass a wide range of conditions historically arising primarily from odontogenic sources and involving deep fascial spaces. In recent years, however, a distinct shift has occurred, marked by the rising prevalence of medication-related osteonecrosis of the jaw (MRONJ). Once considered rare, MRONJ now represents a significant aetiological factor in maxillofacial infections, especially in patients receiving antiresorptive or antiangiogenic therapy. A key dimension in this evolving profile is the role of peri-apical lesions of endodontic origin. Chronic inflammatory foci from inadequately treated root canal infections, apical periodontitis, or persistent radicular cysts may interact unfavourably with medication-compromised bone, increasing the risk of secondary infection and impaired healing. Distinguishing between conventional endodontic pathology and MRONJ-related infection remains a critical diagnostic challenge, as overlapping clinical and radiographic features may lead to delayed or inappropriate management. Thus, precise differential diagnosis is essential to guide effective therapeutic decision-making and prevent unnecessary surgical interventions. Current strategies range from conservative infection control to combined protocols incorporating surgical debridement, systemic antimicrobials, and adjunctive therapies. Preventive measures, including high-quality endodontic treatment and regular follow-up, are fundamental to reducing risk. Overall, the literature highlights MRONJ as both a therapeutic challenge and a driver of change in clinical practice, underscoring the importance of integrating surgical, medical, and endodontic perspectives in managing contemporary maxillofacial infections.

Keywords: maxillofacial infections, bone lesions, medication-related osteonecrosis of the jaw, MRONJ, antimicrobial therapy, surgical management, prevention

How to Cite?: Konstantin Stamatov, "Shifting Trends in Maxillofacial Infections: The Impact of MRONJ - Overview of the Literature", Volume 14 Issue 10, October 2025, International Journal of Science and Research (IJSR), Pages: 752-755, https://www.ijsr.net/getabstract.php?paperid=SR251012011225, DOI: https://dx.doi.org/10.21275/SR251012011225