Tumor Necrosis Factor Alpha (TNFα) inhibitors are common anti-inflammatory medications. In a review of the literature, TNFα inhibitors resulted in six patients with osteonecrosis of the jaw (ONJ) or osteomyelitis (OM) that were attributed solely to TNFα inhibitors. The most common site of ONJ was the posterior mandible (n=5). The mean (SD) duration of anti-TNF-α treatment before the development of bony lesions was 62.5 (47.4) months. Invasive surgery was reported as a precipitating factor in five cases, and the ONJ/OM resolved with conservative management in five.
Osteonecrosis and osteomyelitis of the jaw associated with tumour necrosis factor-alpha (TNF-α) inhibitors: a systematic review. Br J Oral Maxillofac Surg. 2020 Jan;58(1):25-33. doi: 10.1016/j.bjoms.2019.09.023. Epub 2019 Oct 20.