Duration of administration of related medications, presence of bacterial infections in necrotic areas, and methods of treatment have been suggested as factors related to the recurrence of MRONJ. The purpose of this study was to investigate recurrence risk factors in patients who had undergone surgical treatment. The recurrence rate was statistically significant when the teeth affected by alveolar bone necrosis were removed together. When comparing patients who received post-operative antibiotic treatment, recurrence was significantly reduced. Comprehensive surgical approaches, including the extraction of adjacent teeth during surgery, and appropriate post-operative antibiotic therapy can be effective strategies for reducing the recurrence rate of MRONJ.