Outcome of surgical management of bisphosphonate-related osteonecrosis of the jaws: review of 33 surgical cases.
OBJECTIVE
We describe our experience with surgical management of bisphosphonate-related osteonecrosis of the jaws (BRONJ).


METHODS
The data included 33 BRONJ cases treated surgically by a single surgeon at the Hospital of the University of Pennsylvania.


RESULTS
Of the 30 debridement patients, 25 (including 1 sequestrectomy patient who required formal debridement) healed completely. Of the 30 patients who underwent surgical debridement, 18 healed following this initial treatment and remained healed. Of the 4 patients requiring sequestrectomy, 3 healed after the initial treatment. Thus, 28 of 33 patients healed completely with complete mucosal coverage and elimination of pain. Four patients developed occurrence of BRONJ at a separate site. All 4 patients were treated with our surgery protocol and remain healed. Thus, 32 of 37 BRONJ occurrences have healed with our surgical debridement protocol or sequestrectomy. The follow-up range was 1 to 40 months (average 10.7).


CONCLUSIONS
The results of our case series have shown that surgical debridement can be successful in treating BRONJ.
Stanton
David C
DC
Department of Oral and Maxillofacial Surgery, University of Pennsylvania Health System and School of Dental Medicine, Philadelphia, PA 19104, USA. david.stanton@uphs.upenn.edu
Balasanian
Edward
E
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019386:Alendronate / Q000009:adverse effects; D050071:Bone Density Conservation Agents / Q000009:adverse effects*; D004164:Diphosphonates / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007093:Imidazoles / Q000009:adverse effects; D007571:Jaw Diseases / Q000139:chemically induced* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010020:Osteonecrosis / Q000139:chemically induced* / Q000601:surgery*; D000077268:Pamidronate; D016896:Treatment Outcome; D000077211:Zoledronic Acid
D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D007093:Imidazoles; D000077211:Zoledronic Acid; D000077268:Pamidronate; D019386:Alendronate