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Surgical management of bisphosphonate-related osteonecrosis of the jaw stages II and III

Objective - The value of surgery in advanced stages of bisphosphonate-related osteonecrosis of the jaw (BRONJ) is still controversial. Hence, we evaluated the effect of surgical therapy in BRONJ stages II and III in combination with a standardized perioperative adjuvant treatment. - Study Design - W...

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Main Authors: Bodem, Jens (Author) , Schaal, Carolin (Author) , Kargus, Steffen (Author) , Saure, Daniel (Author) , Mertens, Christian (Author) , Engel, Michael (Author) , Hoffmann, Jürgen (Author) , Freudlsperger, Christian (Author)
Format: Article (Journal)
Language:English
Published: 2016
In: Oral surgery, oral medicine, oral pathology, oral radiology, and endodontology
Year: 2016, Volume: 121, Issue: 4, Pages: 367-372
ISSN:1528-395X
DOI:10.1016/j.oooo.2015.10.033
Online Access:Verlag, Volltext: https://doi.org/10.1016/j.oooo.2015.10.033
Verlag, Volltext: http://www.sciencedirect.com/science/article/pii/S2212440315012961
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Author Notes:Jens Philipp Bodem, MD, DDS, Carolin Schaal, DDS, Steffen Kargus, MD, DDS, Daniel Saure, PhD, Christian Mertens, DDS, Michael Engel, MD, DDS, Jürgen Hoffmann, MD, DDS, and Christian Freudlsperger, MD, DDS
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Summary:Objective - The value of surgery in advanced stages of bisphosphonate-related osteonecrosis of the jaw (BRONJ) is still controversial. Hence, we evaluated the effect of surgical therapy in BRONJ stages II and III in combination with a standardized perioperative adjuvant treatment. - Study Design - We included 39 patients who presented with BRONJ in a total of 47 locations and stages II (n = 23) and III (n = 24). All patients had exclusively received a monthly intravenous application of zoledronic acid. Surgical therapy consisted of complete removal of the necrotic jaw, accompanied by a standardized perioperative adjuvant treatment including intravenous antibiotic prophylaxis, gastric feeding, and an antimicrobiologic mouth rinsing. - Results - Overall, 35 (74.5%) of the 47 BRONJ sites were treated successfully, with success defined as complete mucosal healing of the exposed jaw (n = 24) or as relative healing when surgical therapy downscaled BRONJ II or III to asymptomatic BRONJ stage I (n = 11). Interestingly, perioperative adjuvant treatment or bisphosphonate therapy parameters showed no statistical effect on the treatment outcome. - Conclusions - The results of the present study prove the effectiveness of surgical therapy for BRONJ stage II or III.
Item Description:Available online 1 December 2015
Gesehen am 11.02.2020
Physical Description:Online Resource
ISSN:1528-395X
DOI:10.1016/j.oooo.2015.10.033

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