title: Treatment results of bisphosphonate-related osteonecrosis of the jaws.
abstract: BACKGROUND
  Osteonecrosis of the jaws occurs after the administration of bisphosphonates. An unequivocal treatment strategy is yet to be devised. We assess the treatment of patients with bisphosphonate-related osteonecrosis of the jaws (BRONJ).
  
  
  METHODS
  The investigators studied a prospective cohort of 58 patients 6 months after surgical treatment of BRONJ. Outcome variables were the status of the mucosa, the visual analog score of pain, and prosthetic rehabilitation. Preoperative staging results were compared with the postoperative outcome and statistically evaluated.
  
  
  RESULTS
  Of 58 patients, 41 surgically treated patients could be followed up after a mean period of 189 (+/-23) days. Twenty-four (58.5%) were free of pain and had an intact mucosa. A statistically significant improvement was registered between preoperative and postoperative staging (p <.01); 11 of 12 patients who had been treated with a flap procedure for soft tissue closure had an intact mucosa.
  
  
  CONCLUSIONS
  This is the first prospective study to report the outcome of treatment in a cohort of patients with BRONJ. Minimal resection of necrotic bone and local soft tissue closure might be a feasible treatment strategy in patients with established BRONJ.
authors.affiliation: University Hospital of Cranio-, Maxillofacial and Oral Surgery, Medical University of Vienna, Vienna, Austria. arno.wutzl@meduniwien.ac.at
authors.forename: Arno
authors.initials: A
authors.lastname: Wutzl
authors.forename: Edwin
authors.initials: E
authors.lastname: Biedermann
authors.forename: Felix
authors.initials: F
authors.lastname: Wanschitz
authors.forename: Rudolf
authors.initials: R
authors.lastname: Seemann
authors.forename: Clemens
authors.initials: C
authors.lastname: Klug
authors.forename: Arnulf
authors.initials: A
authors.lastname: Baumann
authors.forename: Franz
authors.initials: F
authors.lastname: Watzinger
authors.forename: Kurt
authors.initials: K
authors.lastname: Schicho
authors.forename: Rolf
authors.initials: R
authors.lastname: Ewers
authors.forename: Gabriele
authors.initials: G
authors.lastname: Millesi
mesh_terms: D000284:Administration, Oral; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D004164:Diphosphonates / Q000008:administration & dosage / Q000009:adverse effects*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007275:Injections, Intravenous; D007571:Jaw Diseases / Q000139:chemically induced* / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010020:Osteonecrosis / Q000139:chemically induced* / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D010024:Osteoporosis / Q000139:chemically induced / Q000188:drug therapy / Q000517:prevention & control; D012189:Retrospective Studies; D012720:Severity of Illness Index; D017678:Sex Distribution
chemical_list: D004164:Diphosphonates