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Some cases have been bilateral and occurred spontaneously but the pathogenesis is unclear with similar risk factors for MRONJ proposed

Ideal candidates for this treatment include individuals managing conditions such as Type 1 diabetes, Type 2 diabetes, prediabetes, insulin resistance, or diabetic neuropathy

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References 1 CairnsN

However, as CD4/CD8 DN differentiation continues into stages that engage signaling through the pre-T cell receptor (TCR) complex, thymocytes begin to upregulate mitochondrial metabolism with an increasing reliance upon OXPHOS

Many patients notice improvement within hours of treatment and report sustained benefit for several days to a week or longer