Medication-related osteonecrosis of the jaw (MRONJ) occurs in patients with a history of bisphosphonate therapy due to inhibition of osteoclast-mediated bone resorption, leading to impaired bone remodeling and healing. The hallmark clinical finding is exposed necrotic bone in the mandible or maxilla lasting more than 8 weeks without prior radiation to the area. MRONJ is different from osteomyelitis as it is primarily a drug-induced avascular necrosis rather than an infectious process. Surgical management should prioritize conservative debridement to minimize worsening of necrosis and preserve bone. Early diagnosis and avoidance of invasive dental procedures are essential to prevent progression.

Reference: Oral and Maxillofacial Pathology, Neville, 4th Edition.