Jaw Osteonecrosis Rare in Romosozumab Patients After Dental Surgery, Study Finds

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Posted: July 15, 2026

Jaw Osteonecrosis Rare in Romosozumab Patients After Dental Surgery, Study Finds

Edited by Dentaltown staff

A single case of medication-related osteonecrosis of the jaw occurred among 201 osteoporosis patients who underwent 303 invasive dental procedures after treatment with the bone-building drug romosozumab, sold as Evenity, and that case involved several stacked bone-modifying drugs rather than romosozumab alone. The retrospective study was published July 13 in Clinical Oral Investigations.

The lone case developed in a patient who had received denosumab, then romosozumab, followed by intravenous zoledronic acid, and who also had a local dental infection. Because the osteonecrosis emerged during cumulative and sequential antiresorptive exposure alongside infection, the authors said they could not establish a causal link with romosozumab used on its own.

Researchers reviewed electronic medical records and prescription data from Yonsei University Dental Hospital in Seoul, South Korea, for patients treated between 2019 and 2024 who had at least six months of follow-up. The 303 procedures included 231 extractions and 72 implant placements. Extractions were most often performed for retained roots, caries, periodontal disease, and fractures.

Timing relative to romosozumab varied. About a quarter of procedures were done before the drug was administered, roughly 60% afterward, and the remainder both before and after. Osteonecrosis was classified using American Association of Oral and Maxillofacial Surgeons criteria.

The analysis was descriptive, and the authors cautioned that larger studies are needed to gauge how treatment sequence and cumulative antiresorptive exposure affect risk. They advised clinicians managing patients on romosozumab to account for a patient’s full history of bone-modifying drugs, watch for local infection, and coordinate closely with the prescribing physician.

The study was conducted by Wonse Park and colleagues in the College of Dentistry at Yonsei University. The authors reported no competing interests.

Sources:
Clinical Oral Investigations, “Osteoporosis medication exposure patterns and MRONJ occurrence in patients receiving romosozumab: a retrospective observational study,” July 13, 2026. DOI: 10.1007/s00784-026-06996-4. PMID: 42437851: link.springer.com/article/10.1007/s00784-026-06996-4


Jaw Osteonecrosis Rare in Romosozumab Patients After Dental Surgery, Study Finds

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