title: A prospective clinical trial for assessing the efficacy of a minimally invasive protocol in patients with bisphosphonate-associated osteonecrosis of the jaws.
abstract: OBJECTIVE
  The objective of this study was to assess whether a minimally invasive protocol can be effective in the long-term control of necrotic areas and pain in patients suffering osteonecrosis of the jaw associated with the use of bisphosphonate drugs (BRONJ).
  
  
  METHODS
  Thirty-four consecutive patients (14 male, 20 female) with BRONJ under treatment with zoledronate, pamidronate, or alendronate were enrolled. All of the patients received professional oral hygiene treatment and antiseptic oral rinses, and if in pain they assumed an antibiotic therapy with amoxicillin/clavulanate potassium and metronidazole for ten days. At the baseline visit, as well as at each 3-month recall, the size of the osteonecrotic lesions were measured and the pain level assessed with a visual analog scale.
  
  
  RESULTS
  The results from the general linear model showed a statistically significant (F = 16.1; P < .01; r(2) = 0.95) time-related decrease in the size of exposed bone areas during the nonsurgical therapy (from 12.5 ± 12.0 mm to 8.8 ± 10.3 mm).
  
  
  CONCLUSIONS
  This conservative protocol seems to provide successful treatment in the vast majority of patients.
authors: Department of Oral Science, University of Bologna, Bologna, Italy.
authors: Filippo
authors: F
authors: Moretti
authors: Gian Andrea
authors: GA
authors: Pelliccioni
authors: Lucio
authors: L
authors: Montebugnoli
authors: Claudio
authors: C
authors: Marchetti
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019386:Alendronate / Q000009:adverse effects; D019980:Amoxicillin-Potassium Clavulanate Combination / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000890:Anti-Infective Agents / Q000627:therapeutic use; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use; D059266:Bisphosphonate-Associated Osteonecrosis of the Jaw / Q000209:etiology / Q000517:prevention & control*; D050071:Bone Density Conservation Agents / Q000009:adverse effects; D002710:Chlorhexidine / Q000031:analogs & derivatives / Q000627:therapeutic use; D004164:Diphosphonates / Q000009:adverse effects; D004338:Drug Combinations; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007093:Imidazoles / Q000009:adverse effects; D008297:Male; D008795:Metronidazole / Q000627:therapeutic use; D008875:Middle Aged; D009067:Mouthwashes / Q000627:therapeutic use; D009910:Oral Hygiene; D010147:Pain Measurement; D000077268:Pamidronate; D011446:Prospective Studies; D012459:Salicylates / Q000627:therapeutic use; D013729:Terpenes / Q000627:therapeutic use; D016896:Treatment Outcome; D000077211:Zoledronic Acid
chemical_list: D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents; D000891:Anti-Infective Agents, Local; D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D004338:Drug Combinations; D007093:Imidazoles; D009067:Mouthwashes; D012459:Salicylates; D013729:Terpenes; D008795:Metronidazole; C057473:Listerine; D000077211:Zoledronic Acid; D019980:Amoxicillin-Potassium Clavulanate Combination; C010882:chlorhexidine gluconate; D000077268:Pamidronate; D002710:Chlorhexidine; D019386:Alendronate