## 1 Introduction  
Bisphosphonate-related osteonecrosis of the jaw (BRONJ) was first reported in 2003 by [PERSON] [1] and has chiefly involved patients receiving intravenous bisphosphonates for the treatment of bone-related malignancies [2]. It has primarily been reported in patients with bisphosphonate-related osteonecrosis of the jaw (BRONJ), but other antiresorptic drugs, such as denosumab, are also considered a risk factor for osteonecrosis of the jaw [3, 4]. Further, ONJ is also associated with the intake of antiangiogenics for cancer treatment [5, 6] and immunomodulators for [PERSON]'s disease or rheumatic arthritis [7, 8]. Inhibitors of osteoclast differentiation and function have been introduced in the pharmacologic society for the treatment of diseases, causing a decreased bone turnover. However, the continued advent of new and complex therapies will eventually lead to an increase in the number of drugs inducing ONJ. The name of the disease was therefore revised from BRONJ to MRONJ and subsequently to drug-induced osteonecrosis of the jaw (DIONJ) [9]. After the first position statement on MRONJ in 2007, the American Association of Oral and Maxillofacial Surgeons (AAOMS) updated the position paper on strategies for the management of MRONJ in 2009 and 2014 [10], with the latest update in 2022. Although the most suitable treatment option for large bony defects in MRONJ remains debatable, AAOMS now cautiously recommends operative methods [11]. A nonoperative approach for MRONJ does not guarantee disease resolution. Early surgical intervention can provide good outcomes and should therefore be considered to inhibit disease progression [12]. Segmental or marginal resection of the mandible and partial maxillectomy are reliable methods to control MRONJ [13] and can be adopted during any stage of the disease, including stage 1 MRONJ [14]. After resecting the diseased part of the jaw, several reconstruction techniques can be used. A popular technique involves placement of a vascularized bone graft, which is the gold standard for mandibular reconstruction. The most common donor sites for osseous free-tissue grafts include the fibula, scapula, iliac bone, and radius [15]. Although the fibula free flap graft has been shown to be promising, it remains controversial due to requirements of advanced skill and technology and reports of postoperative progression of jaw bone necrosis, ONJ recurrence [16], and frequent failure caused by venous thrombosis [17]. In addition, this graft requires a donor site and is associated with a risk of donor site morbidity, which affects the quality of life of patients [18]. Other reconstruction techniques, such as distraction osteogenesis, which is very similar to the palatal distraction frequently used in orthodontic treatment, and the induced membrane technique (Masquelet technique), are other technical options [19; 20]. The Masquelet technique can be summarized in two stages. The first stage consists of meticulous debridement at the lesion site, maintaining the stability of fracture ends, and implanting a polymethylmethacrylate cement spacer into the created bone defect. During the second stage with an interval of 6 to 8 weeks, the cement spacer is removed and the autologous bone graft is inserted. However, this method also requires a bone graft and a secondary surgery. Furthermore, these other options are also technical-sensitive and time-consuming [20]. Nonvascularized autogenous bone grafts or spontaneous regeneration of the bony defects without grafts constitute another reliable option for mandibular reconstruction [21; 22]. These procedures utilize rigid plates made of titanium known as reconstruction plates (R-plates). R-plates are placed on the border of the mandible to bridge and stabilize the residual bone segments and defects. They can easily be used to maintain occlusion and the facial contour without modification. R-plates are used to affix nonvascularized autogenous bone grafts to the mandibular segments [23].