The Special Committee on Medication-Related Osteonecrosis of the Jaws (MRONJ) has recommended changing the terminology from bisphosphonate-related osteonecrosis of the jaw (BRONJ) to medication-related osteonecrosis of the jaw (MRONJ) to better reflect the growing number of cases associated with other antiresorptive and antiangiogenic therapies. MRONJ significantly impacts patients' quality of life and morbidity. The American Association of Oral and Maxillofacial Surgeons (AAOMS) updated its Position Paper on MRONJ in 2009, and this update revises diagnosis, staging, and management strategies based on current knowledge. The purpose of the updated position paper is to provide risk estimates, comparisons of risks and benefits of medications related to osteonecrosis of the jaw (ONJ), and guidance for clinicians in diagnosing and managing MRONJ. The paper highlights the importance of early dental screening and preventive measures to reduce the risk of ONJ, especially in patients receiving antiresorptive or antiangiogenic therapy. The pathophysiology of MRONJ is complex, involving factors such as inhibition of osteoclastic bone resorption, inflammation/infection, inhibition of angiogenesis, soft tissue toxicity, and immune dysfunction. The risk factors for MRONJ include medication-related factors, local factors, demographic and systemic factors, and genetic factors. The risk is higher in cancer patients receiving antiresorptive therapy compared to osteoporosis patients, but remains very low in the latter group. Management strategies for patients at risk or with established MRONJ focus on prevention, early intervention, and appropriate dental care. For patients about to initiate antiresorptive or antiangiogenic treatment, it is recommended to optimize dental health before starting therapy. For asymptomatic patients, maintaining good oral hygiene and avoiding procedures that involve osseous injury are crucial. For patients with established MRONJ, the goal is to eliminate pain, control infection, and minimize bone necrosis progression. Operative and non-operative therapies are available, but more research is needed to establish their efficacy. The staging system has been revised to better reflect disease presentation and guide treatment. Stage 0 includes patients with non-specific symptoms or findings, Stage 1 involves exposed and necrotic bone without infection, and Stage 2 involves exposed and necrotic bone with infection.The Special Committee on Medication-Related Osteonecrosis of the Jaws (MRONJ) has recommended changing the terminology from bisphosphonate-related osteonecrosis of the jaw (BRONJ) to medication-related osteonecrosis of the jaw (MRONJ) to better reflect the growing number of cases associated with other antiresorptive and antiangiogenic therapies. MRONJ significantly impacts patients' quality of life and morbidity. The American Association of Oral and Maxillofacial Surgeons (AAOMS) updated its Position Paper on MRONJ in 2009, and this update revises diagnosis, staging, and management strategies based on current knowledge. The purpose of the updated position paper is to provide risk estimates, comparisons of risks and benefits of medications related to osteonecrosis of the jaw (ONJ), and guidance for clinicians in diagnosing and managing MRONJ. The paper highlights the importance of early dental screening and preventive measures to reduce the risk of ONJ, especially in patients receiving antiresorptive or antiangiogenic therapy. The pathophysiology of MRONJ is complex, involving factors such as inhibition of osteoclastic bone resorption, inflammation/infection, inhibition of angiogenesis, soft tissue toxicity, and immune dysfunction. The risk factors for MRONJ include medication-related factors, local factors, demographic and systemic factors, and genetic factors. The risk is higher in cancer patients receiving antiresorptive therapy compared to osteoporosis patients, but remains very low in the latter group. Management strategies for patients at risk or with established MRONJ focus on prevention, early intervention, and appropriate dental care. For patients about to initiate antiresorptive or antiangiogenic treatment, it is recommended to optimize dental health before starting therapy. For asymptomatic patients, maintaining good oral hygiene and avoiding procedures that involve osseous injury are crucial. For patients with established MRONJ, the goal is to eliminate pain, control infection, and minimize bone necrosis progression. Operative and non-operative therapies are available, but more research is needed to establish their efficacy. The staging system has been revised to better reflect disease presentation and guide treatment. Stage 0 includes patients with non-specific symptoms or findings, Stage 1 involves exposed and necrotic bone without infection, and Stage 2 involves exposed and necrotic bone with infection.