Treatment results of bisphosphonate-related osteonecrosis of the jaws.
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.
Wutzl
Arno
A
University Hospital of Cranio-, Maxillofacial and Oral Surgery, Medical University of Vienna, Vienna, Austria. arno.wutzl@meduniwien.ac.at
Biedermann
Edwin
E
Wanschitz
Felix
F
Seemann
Rudolf
R
Klug
Clemens
C
Baumann
Arnulf
A
Watzinger
Franz
F
Schicho
Kurt
K
Ewers
Rolf
R
Millesi
Gabriele
G
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
D004164:Diphosphonates