## 1 Introduction  
One of the most serious side effects associated with the use of particular drugs is a condition known as medication-related osteonecrosis of the jaw (MRONJ). This condition is induced primarily by antiresorptive drugs and angiogenesis inhibitors [1, 2]. Commonly, these drugs are used to treat the skeletal signs and symptoms of primary or secondary bone metastases. In addition, these medications are also used to manage chronic benign bone conditions such as osteoporosis or Paget's disease [3; 4]. Other substances, such as the inhibitors of the tumour necrosis factor-\(\alpha\) (TNF-\(\alpha\)), have been linked to osteonecrosis of the jaw (ONJ) in a growing number of scientific investigations since 2003 [5; 6; 7]. Hence, the American Association of Oral and Maxillofacial Surgeons (AAOMS) in 2014 proposed the nomenclature of MRONJ due to the possible association with different drugs and the ONJ [8]. This positional paper has been recently updated in 2022 [9]. The prevalence of MRONJ varies depending on a number of other factors, including a patient's medical history, pharmacological therapy, length of therapy, and dental therapies [8]. According to studies, the incidence of MRONJ following a tooth extraction is predicted to range from 1.6-14.8% for cancer patients using intravenous bisphosphonates, with a mean incidence of 7% [8; 10]. This contrasts with an incidence of MRONJ of 0.05% in individuals using oral bisphosphonates and 1.8% in cancer patients receiving denosumab [8; 9; 10; 11; 12]. Furthermore, there is an increased risk of MRONJ development when antiangiogenic medicines are used with antiresorptive medications, with an estimated 16% recurrence rate [13]. According to a number of studies, dental extractions are the leading cause of MRONJ, with prevalence rates ranging from 48.5% all the way up to 80% in some cases [14]. Recently, it was discovered that MRONJ can be triggered by tooth extraction (61.7%), spontaneous onset (14.8%), or ill-fitting dentures (7.4%) in the same proportions regardless of the route of drug administration [15]. Denosumab-related MRONJ is, however, a subject of limited investigation. There are many different factors that could cause and increase the severity of osteonecrosis of the jaw. Most of them are not completely understood due to their unclear aetiopathogenesis [16; 17; 18; 19]. Since the first study that was ever published detailing ONJ, over the course of the previous two decades, researchers have attempted to understand the underlying molecular process that is responsible for this disease [5]. Despite the fact that various risk factors have been identified and linked to an increased incidence of MRONJ development, the exact aetiology and pathophysiology of MRONJ are still not fully understood. These risk factors consist of the potency and route of administration of the antiresorptive agent (intravenous bisphosphonate versus oral), the underlying disease (oncology versus osteoporosis), the duration and cumulative dosage of antiresorptive therapy, and the requirement for dentoalveolar surgery or the presence of dental infections [19; 20; 21]. In recent years, pharmacogenetics represents a promising approach to address the potential predisposition and pathogenesis of MRONJ [22]. These studies were designed to find out whether or not changes in patients' genetic makeup can have an effect on how they react to different medications. In order to gain a better understanding of the many forms of genetic differences, a large number of genome-wide association studies (GWAS), candidate gene studies (CGs), and whole-genome studies (WGs) have been conducted [22; 23]. These particular investigations have used single nucleotide polymorphisms (SNPs) to investigate a potential link. It is believed that the human genome has approximately 10 million SNPs, which are often located in the DNA between genes and have low or no effect on the phenotype [24].