Development of Medication-related Osteonecrosis of the Jaw Associated with Dental Implant: Report of Two Cases

Medication-related osteonecrosis of the jaw (MRONJ) is a known complication of antiresorptive therapy.Although its pathogenesis remains unclear, several studies have reported MRONJ development around osseointegrated implants.This study presents two cases of implant-associated MRONJ and discusses the relevant risk factors and management approaches.The first case involved a 68-year-old woman who had been receiving oral bisphosphonate therapy for approximately 6 years and presented with persistent pain around mandibular implants without any notable evidence of bone destruction.Despite multiple conservative and surgical interventions, the symptoms persisted.Complete mucosal healing was achieved after removal of the adjacent tooth and sequestrectomy with reimplantation.The second case involved a 72-year-old woman who developed MRONJ around implants in multiple regions.She had been receiving bisphosphonate and corticosteroid therapy.Repeated sequestrectomies and implant removals were required to control the disease, followed by successful healing of the mandibular lesions.Clinicians should inform patients that MRONJ can develop even around osseointegrated implants.Furthermore, MRONJ development should be considered in patients undergoing antiresorptive treatment for osteoporosis who present with atypical symptoms around dental implants.