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Medication-related osteonecrosis of the jaw (MRONJ) is a recurring complication resulting from the long-term therapy with bisphosphonates or antiresorptive drugs such as denosumab or antiangiogenic drugs. This paper describes a 5-years follow-up case of Stage 3 of MRONJ (AAOMS) in a 69-year-old patient treated with piezosurgery and topical application of platelet-rich fibrin (PRF). Medical treatment included antibiotic therapy and a topical treatment with PRF in solid and liquid form. This treatment showed initially the reduction of pain and leakag