Methotrexate associated osteonecrosis of the jaw: a report of two cases

There has been a rise in medication related osteonecrosis of the jaws (MRONJ) predominantly related to anti-resorptive and anti-angiogenic medications. More evidence is revealing that MRONJ is not limited to these drug groups. With the introduction of newer and varied medications used in the treatment of cancer and autoimmune diseases, reports of possible related osteonecrosis of the jaw (ONJ) are also on the rise. We present two cases of ONJ in patients with long-standing arthritis treated with methotrexate in the absence of a lymproliferative disorder and anti-resorptive or anti-angiogenic medications.

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