This retrospective study evaluated the efficacy of bone regeneration following decortication and sequestrectomy combined with the application of recombinant human bone morphogenetic protein-2/absorbable collagen sponge (rhBMP-2/ACS) in 45 patients with medication-related osteonecrosis of the jaw (MRONJ). Each patient received 0.25 g of rhBMP-2/ACS at the surgical site. Facial computed tomography scans were obtained immediately postoperatively and at a six-month follow-up to assess volumetric changes in the alveolar bone. The results indicated that rhBMP-2 significantly enhanced bone regeneration. Notably, the number of residual bone walls was the only significant factor influencing the regenerative outcome (B = 19.47, standard error = 3.05, t = 6.39, p < 0.001). Four-wall defects exhibited the highest regeneration rate (85.2%), and the mandibular posterior region was the most frequently involved site (60.5%). Complications such as surgical site disruption did not significantly impact the regenerative outcomes. These findings suggest that the concomitant use of rhBMP-2 with decortication and sequestrectomy promotes bone healing, reduces recovery time, and improves treatment predictability for patients with MRONJ.

Introduction
Materials and Methods
    1. Patients
    2. Material and methods
    3. Statistical analysis
    4. Surgical protocol
Results
Discussion
Funding
Acknowledgements
Conflicts of Interest
References

• Chan-Sik Yoon(Department of Oral and Maxillofacial Surgery, Sun Dental Hospital, Daejeon 34813, Republic of Korea)
• Min-Seok Oh(Department of Oral and Maxillofacial Surgery, Sun Dental Hospital, Daejeon 34813, Republic of Korea)
• Chul-Min Park(Department of Oral and Maxillofacial Surgery, Sun Dental Hospital, Daejeon 34813, Republic of Korea)
• Woo-Jin Jeon(Department of Oral and Maxillofacial Surgery, Sun Dental Hospital, Daejeon 34813, Republic of Korea)
• Kil-Hwa Yoo(Department of Oral and Maxillofacial Surgery, Sun Hospital, Daejeon 34811, Republic of Korea) Corresponding author