Review Article

Microsurgical Reconstruction of the Jaws Using Vascularised Free Flap Technique in Patients with Medication-Related Osteonecrosis: A Systematic Review

Table 4

MRONJ staging according the AAOMS [7].

StageMRONJ clinical findings

At risk categoryNo apparent necrotic bone in patients who have been treated with either oral or IV bisphosphonates

Stage 0No clinical evidence of necrotic bone, but non-specific clinical findings, radiographic changes and symptoms

Stage IExposed and necrotic bone, or fistulae that probes to bone, in patients who are asymptomatic and have no evidence of infection

Stage IIExposed and necrotic bone, or fistulae that probes to bone, associated with infection as evidenced by pain and erythema in the region of the exposed bone with or without purulent drainage

Stage IIIExposed and necrotic bone or a fistula that probes to bone in patients with pain, infection, and one or more of the following: exposed and necrotic bone extending beyond the region of alveolar bone, (i.e., inferior border and ramus in the mandible, maxillary sinus and zygoma in the maxilla) resulting in pathologic fracture, extra-oral fistula, oral antral/oral nasal communication, or osteolysis extending to the inferior border of the mandible of sinus floor