TITLE:
Non-Surgical Treatment of Medication-Related Osteonecrosis of the Jaw with Essential Oils: A Case Report
AUTHORS:
Nadya Markova, Zdravka Garkova
KEYWORDS:
MRONJ, Oncology Patient, Non-Surgical Treatment, Essential Oils
JOURNAL NAME:
Journal of Biosciences and Medicines,
Vol.14 No.7,
July
7,
2026
ABSTRACT: Medication-related osteonecrosis of the jaw (MRONJ) is a severe adverse reaction associated with antiresorptive therapy, where non-surgical treatment remains limited. We report the case of a 70-year-old female patient with breast cancer and bone metastases, who developed stage 2 MRONJ after treatment with denosumab. Due to contraindications for surgical intervention, a conservative, integrative therapeutic approach was adopted, using the topical application of a specific combination of essential oils (EOsZG). Notably, 260 days after initiating this therapy, the patient spontaneously expelled a 2 cm necrotic bone sequestrum, marking a critical turning point that demonstrated a favorable response, leading to rapid symptom resolution and progressive soft-tissue healing. In conclusion, local treatment with essential oils may facilitate sequestrum demarcation and spontaneous separation. The therapeutic effects are likely driven by the antimicrobial activity of EOsZG, their penetrative capacity of necrotic tissue, enhancement of local microcirculation and accelerated debris removal via leukocyte activation between necrotic and healthy tissue. This case suggests topical essential oil therapy is a viable, effective non-surgical strategy that results in significant improvement in MRONJ.