IMPLICACIONES ODONTOLÓGICAS DE LA TERAPIA CON BISFOSFONATOS: UNA REVISIÓN SOBRE LA OSTEONECROSIS DE LOS MAXILARES INDUCIDA POR MEDICAMENTOS

Introduction: Bisphosphonates are essential antiresorptive drugs used in the treatment of bone diseases such as osteoporosis and cancer with bone metastases. Despite their benefits, they have been associated with significant adverse effects, such as medication-related osteonecrosis of the jaw, a serious complication that impacts both oral and systemic health. Objective: To synthesize scientific evidence on the effects of bisphosphonates in the oral cavity, with an emphasis on medication-related osteonecrosis of the jaw, including its risk factors, clinical manifestations, and management strategies. Methodology: A narrative review of national and international scientific literature focusing on recent studies about the effects of bisphosphonates and clinical-dental approaches to MRONJ. The review integrates data on pharmacology, risk factors, clinical presentations, and both preventive and therapeutic strategies. Results: Medication-related osteonecrosis of the jaw most commonly affects oncology patients treated with intravenous bisphosphonates. Risk is increased by factors such as route of administration, treatment duration, systemic diseases, and invasive dental procedures. Clinical manifestations include persistent bone exposure, pain, and recurrent infections. In dentistry, risks have been identified in surgical procedures, orthodontics, periodontics, endodontics, and implantology. Prevention, early diagnosis, and coordinated medical-dental care are essential. Conclusions: Medication-related osteonecrosis of the jaw represents a clinical challenge that demands updated knowledge and preventive strategies based on dental evaluation prior to initiating treatment. Multidisciplinary management, patient education, and close monitoring are essential to minimize risks and preserve both oral and systemic health in patients undergoing bisphosphonate therapy.