Denosumab-related osteonecrosis of the jaw: a report of 2 cases and review of the literature.

Bisphosphonates have been implicated in the induction of medication-related osteonecrosis of the jaw (MRONJ) since 2004. Since then, the spectrum of drugs implicated in the onset of MRONJ has broadened to include other antiresorptive and antiangiogenic drugs. Denosumab is an antiresorptive drug that has been on the market since 2010. Denosumab inhibits osteoclast formation, function, and survival and increases bone mineral density. As a result, denosumab is indicated for the treatment of osteoporosis and bone metastases. This article reports 2 cases of MRONJ associated with denosumab use. The characteristics and progression of MRONJ in patients who take denosumab are reviewed, and therapeutic measures are discussed.