Medication‐related osteonecrosis of the jaw‐like lesions in rodents: A comprehensive systematic review and meta‐analysis

Objective The aim of this comprehensive systematic review and meta‐analysis was to investigate the pathology and pathogenesis of medication‐related osteonecrosis of the jaw (MRONJ) in rodents. Background Medication‐related osteonecrosis of the jaw occurs in patients taking antiresorptive drugs, such as bisphosphonates and denosumab, and anti‐angiogenesis agents. However, there is limited information about the pathology of MRONJ at the clinical level. Moreover, no information about the exact mechanisms of MRONJ is clinically available. Materials and methods The PubMed, SCOPUS and Medline databases were used to search for relevant articles up to April 2018 by two independent reviewers. A systematic review and meta‐analysis were performed. Results Of the 1841 studies, 10 articles met the eligibility criteria. The most commonly observed pathology of MRONJ‐like lesions was exposed bone without epithelial coverage, decreases in the number of osteocytes and increases in necrotic bone with more empty lacunae. No definitive pathogenesis of MRONJ‐like lesions was found. Both zoledronic acid (ZA) monotherapy and ZA/chemotherapeutic and/or dexamethasone combination therapy were significant high‐risk factors for developing MRONJ‐like lesions (P