Hasegawa T, et al. - Researchers retrospectively determined the influence of pre-existing inflammation, surgical procedure–related factors (such as primary wound closure), demographic factors, and drug holiday, on the development of medication-related osteonecrosis of the jaw (MRONJ) following tooth extraction in cancer patients receiving high-dose bone-modifying agents (BMAs), like bisphosphonates or denosumab. Using univariate and multivariate analyses, they assessed risk factors for MRONJ following tooth extraction. Findings revealed significant associations of root amputation, immunosuppressive therapy, extraction of mandibular teeth, extraction of teeth with pre-existing inflammation, and longer duration (≥ 8 months) of high-dose BMA, with MRONJ. They recommended that cancer patients receiving high-dose BMA should not necessarily postpone tooth extraction. No remarkable impact of drug holidays on MRONJ incidence was seen, so there was no confirmation on the efficacy of a short-term drug holiday. During high-dose BMA therapy, it may be acceptable to perform tooth extraction until 8 months after initiation.