Treatment outcomes in patients with bisphosphonate-related osteonecrosis of the jaws: a prospective study.
OBJECTIVE
The aim of this study was to evaluate the 2-year success rate of management of patients with bisphosphonate-related osteonecrosis of the jaws (BRONJ).


METHODS
A prospective study was performed. Positive outcome variables were the resolution of symptoms and the status of the mucosa.


RESULTS
A total of 37 patients are described. The precipitating event was a dental extraction in 22 cases (59.5%). Thirteen patients (35.1%) underwent surgery, and 24 (64.9%) underwent antimicrobial therapy alone. After 2 years, 20 patients (54.1%) presented with soft tissue closure over previously exposed bone, and there were no statistical differences in gender, age, bisphosphonate treatment, or treatment modalities. Spontaneous lesions seemed to have a worse prognosis (P = .001).


CONCLUSIONS
Initial antimicrobial treatment, and later surgery for unresponsive patients, might be a feasible treatment modality for BRONJ. Because these results are not conclusive, it would be very interesting to know if this statement would be the same with a greater number of patients.
Scoletta
Matteo
M
Oral Surgery Unit, Dentistry Section, Department of Clinical Physiopathology, University of Turin, Turin, Italy.
Arduino
Paolo G
PG
Dalmasso
Paola
P
Broccoletti
Roberto
R
Mozzati
Marco
M
D000368:Aged; D000428:Alcohol Drinking; D019386:Alendronate / Q000008:administration & dosage; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D050071:Bone Density Conservation Agents / Q000008:administration & dosage / Q000009:adverse effects*; D002908:Chronic Disease; D002981:Clindamycin / Q000627:therapeutic use; D015331:Cohort Studies; D003131:Combined Modality Therapy; D003646:Debridement; D004164:Diphosphonates / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D005598:Fractures, Spontaneous / Q000628:therapy; D006801:Humans; D007093:Imidazoles / Q000008:administration & dosage; D007571:Jaw Diseases / Q000139:chemically induced / Q000601:surgery / Q000628:therapy*; D008297:Male; D016155:Oral Fistula / Q000628:therapy; D010020:Osteonecrosis / Q000139:chemically induced / Q000601:surgery / Q000628:therapy*; D000077268:Pamidronate; D010406:Penicillins / Q000627:therapeutic use; D011446:Prospective Studies; D012074:Remission Induction; D012307:Risk Factors; D012907:Smoking; D014081:Tooth Extraction; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology; D000077211:Zoledronic Acid
D000900:Anti-Bacterial Agents; D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D007093:Imidazoles; D010406:Penicillins; D002981:Clindamycin; D000077211:Zoledronic Acid; D000077268:Pamidronate; D019386:Alendronate