**5.6 Local factors**

Dental procedures that are invasive, such as dentoalveolar surgery, increase the risk of MRONJ up to seven times [3]. From local factors dentoalveolar surgery is considered the most risky factor for the development of medication-related osteonecrosis with an incidence of 60 to 65% [31, 47]. In other dental procedures such as endodontic or periodontal, the incidence of medication-related osteonecrosis is less. Dental diseases that the patient has already overcome, such as periodontitis, periimplantitis, various inflammatory conditions of the jaw and poor oral hygiene are among the additional risk factors conducive to the development of MRONJ [47, 48].
