Osteonecrosis of the jaw unrelated to medication or radiotherapy

Osteonecrosis of the jaw (ONJ) is commonly linked to head and neck radiotherapy (HNRT) or bone-modulating agents (BMAs) but cases unrelated to these are becoming increasingly recognized. This article presents nine non-HNRT/BMA cases managed in tertiary care, following referral by primary care, over 2014–2023. All patients were treated with antibiotics and, in most cases, surgical intervention ranging from sequestrectomy to en bloc resection. All followed-up cases achieved full mucosal coverage. The findings emphasize the role of ischaemia in ONJ pathogenesis and the need for tailored diagnostic and treatment approaches. CPD/Clinical Relevance: General dental practitioners should be aware of causes of ONJ other than head and neck radiotherapy and bone-modulating therapy, which are more rare.