title: The saxon bisphosphonate register - therapy and prevention of bisphosphonate-related osteonecrosis of the jaws.
abstract: In 2009, a study group of three Saxon hospitals set up a Saxon register with the aim of including all patients with bisphosphonate (BP) medication. In addition, specific concepts for surgical approach were developed. The target is to define relevant treatment and prevention strategies of bisphosphonate-related osteonecrosis of the jaws (BRONJ) based on high patient population statistics. Since July 2009, all patients with oral or intravenous BP medication have been registered in the 3 Saxon hospitals. Data was systematically acquired in detailed forms. Totally, 258 patients (♂: 83, ♀: 175) were registered by October 2010. 100 patients out of this already had BRONJ which preferably affected the mandible (70%) and was mostly associated with intravenous medication. In 54 cases, treatment was carried out by surgery according to the strategy developed. The criterion for success was absence of symptoms at least for 3 months after surgery. The following stage-dependent success rates were obtained: stage I (13 patients) - 84.6%, stage II (22 patients) - 95.5%, stage III (14 patients) - 85.7%, stage IV (5 patients) - 80%. Under preventive aspects, teeth were extracted after a predefined scheme in 68 of all patients registered as being asymptomatic. No BRONJ was observed in 98.5%; the criterion also being absence of symptoms for a minimum period of 3 months after surgery. Surgical treatment is the treatment of choice in cases of BRONJ. Tooth extractions are rather unproblematic in asymptomatic patients if the predefined scheme is followed.
authors: Department of Oral and Maxillofacial Surgery, University Hospital Carl Gustav Carus, Technical University Dresden, Fetscherstraße 74, 01307 Dresden, Germany. marika.schubert@uniklinikum-dresden.de
authors: Marika
authors: M
authors: Schubert
authors: Ingolf
authors: I
authors: Klatte
authors: Wigbert
authors: W
authors: Linek
authors: Bianca
authors: B
authors: Müller
authors: Karli
authors: K
authors: Döring
authors: Uwe
authors: U
authors: Eckelt
authors: Alexander
authors: A
authors: Hemprich
authors: Uwe
authors: U
authors: Berger
authors: Jörg
authors: J
authors: Hendricks
mesh_terms: D000284:Administration, Oral; D059266:Bisphosphonate-Associated Osteonecrosis of the Jaw / Q000517:prevention & control / Q000601:surgery*; D050071:Bone Density Conservation Agents / Q000008:administration & dosage / Q000009:adverse effects*; D004164:Diphosphonates / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D011446:Prospective Studies; D014081:Tooth Extraction; D016896:Treatment Outcome
chemical_list: D050071:Bone Density Conservation Agents; D004164:Diphosphonates