Surgical management of medication-related osteonecrosis of the jaw improves quality of life without deterioration in oral function

Although medication-related osteonecrosis of the jaw (MRONJ) is frequently treated surgically, bone resection and tooth loss may compromise oral function. This study longitudinally evaluated patient-reported quality of life (QOL) and objective oral functional parameters following surgical management of MRONJ and explored biological and mechanical factors associated with recurrence. Forty-eight patients with Stage 2–3 MRONJ underwent surgical management and were prospectively followed. QOL was assessed using a validated MRONJ-specific instrument preoperatively and at 6 months. Objective oral functional parameters were evaluated preoperatively and at 3 and 6 months. Longitudinal changes were analyzed using nonparametric repeated-measures models, and recurrence-related factors were explored using regression analyses. Total QOL significantly improved at 6 months. Despite invasive resection procedures, key oral functional parameters remained stable without significant deterioration. Recurrence occurred in 20.8% of patients and was strongly associated with systemic factors, particularly concomitant chemotherapy. Higher masticatory performance, occlusal force, and tongue pressure demonstrated trends toward shorter recurrence-free intervals, suggesting a potential role of mechanical loading. Reduced salivary flow volume was significantly associated with earlier recurrence. These findings suggest that surgical treatment may contribute to restoration of functional equilibrium while highlighting potential biological and mechanical determinants of recurrence.