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.
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
David C
DC
Stanton
Edward
E
Balasanian
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