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

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

Oral Surg Oral Med Oral Pathol Oral Radiol. 2015 Dec 1;

Authors: Bodem JP, Schaal C, Kargus S, Saure D, Mertens C, Engel M, Hoffmann J, Freudlsperger C

Abstract
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.

PMID: 26795450 [PubMed - as supplied by publisher]

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