Solitary Palatal Involvement in Medication-Related Osteonecrosis of the jaws: clinical profile and frequency.

Federico Garola; Nicolás Leonardi; Juan Cruz Romero Panico; Gerardo Gilligan; Luis René Panico

doi:10.5327/2525-5711.495

Authors

Federico Garola Oral Medicine Department, Facultad de Odontología Universidad Nacional de Córdoba https://orcid.org/0000-0001-8639-2057
Nicolás Leonardi Oral Medicine Department, Dentistry School, Health Sciences Faculty, Universidad Católica de Córdoba https://orcid.org/0000-0002-4450-0678
Juan Cruz Romero Panico Oral Medicine Department, Facultad de Odontología Universidad Nacional de Córdoba https://orcid.org/0009-0001-7263-1886
Gerardo Gilligan Oral Medicine Department,Facultad de Odontología, Universidad Nacional de Córdoba, https://orcid.org/0000-0002-5201-1444
Luis René Panico Oral Medicine Department, Facultad de Odontología Universidad Nacional de Córdoba https://orcid.org/0000-0002-5833-5546

DOI:

https://doi.org/10.5327/2525-5711.495

Keywords:

Medication-related osteonecrosis of the jaw, palate, antiresorptive therapy, torus palatinus, bisphosphonates

Abstract

Objective. This study assessed the frequency and clinical features of MRONJ with exclusive palatal involvement at two Oral Medicine referral centers.

Methods. A retrospective cross-sectional study included consecutive patients diagnosed with MRONJ between 2016 and 2025 at two referral centers in Córdoba, Argentina. Clinical records, imaging studies, and histopathological reports were reviewed. The frequency of exclusive palatal involvement was determined, and demographic, clinical, radiographic, and histopathological characteristics were analyzed descriptively.

Results. Among 58 patients with MRONJ, 5 (8.6%) presented exclusive palatal involvement without concomitant maxillary or mandibular lesions. All patients were women (mean age, 78.4 years) receiving oral antiresorptive therapy for osteoporosis. Clinical findings ranged from mucosal breakdown to exposed necrotic bone with fistulization. Contributing local factors included prosthetic irritation and palatal exostoses. Imaging findings were often subtle or non-specific, whereas histopathological examination confirmed osteonecrosis when performed.

Conclusions. Exclusive palatal MRONJ is an uncommon but clinically significant presentation. Awareness of this atypical location may facilitate earlier diagnosis and improve management in patients receiving antiresorptive therapy.

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