title: Bisphosphonate-related osteonecrosis of the jaw (BRONJ): 5 year experience in the treatment of 131 cases with ozone therapy.
abstract: BACKGROUND
  Bisphosphonate-Related Osteonecrosis of the Jaw (BRONJ) are the result of the assumption of such drugs. The most widely used molecules are pamidronate and zoledronic acid, which are pyrophosphate analogues and are usually given to patient with bone remodelling diseases. International literature reports showed an association between this therapy and avascular necrosis, thus leading to review the guidelines for their administer.
  
  
  OBJECTIVE
  The authors present their protocol based upon medical treatment, antibiotic and antimycotic, together with minimally invasive surgery and ozone therapy developed after a 5 year experience to assess the viability of this treatment.
  
  
  METHODS
  In the last years researchers studied treatment protocols, both medical and surgical, for the management of BRONJ. Among these Ozone therapy is being adopted by several centers. From February 2004 and December 2010 a total number of 131 patients affected by BRONJ have been observed. Collected data include patients' age at the time of disorders, gender, presenting signs and symptoms, primary diagnosis, type and characteristics of the treatment performed, radiological findings and post-treatment results.
  
  
  CONCLUSIONS
  At the present time there are no major guidelines in international literature for the treatment of BRONJ, the Authors then propose a therapeutic protocol based upon minimally invasive surgery, antibiotic and anti mycotic therapy with the adoption of ozone as regenerating factor for tissues. In 90% of the cases the results confirmed the procedure with successful outcomes.
authors.affiliation: Department of Maxillo-Facial Surgery, Sapienza University of Rome, Rome, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Agrillo
authors.forename: F
authors.initials: F
authors.lastname: Filiaci
authors.forename: V
authors.initials: V
authors.lastname: Ramieri
authors.forename: E
authors.initials: E
authors.lastname: Riccardi
authors.forename: D
authors.initials: D
authors.lastname: Quarato
authors.forename: C
authors.initials: C
authors.lastname: Rinna
authors.forename: P
authors.initials: P
authors.lastname: Gennaro
authors.forename: F
authors.initials: F
authors.lastname: Cascino
authors.forename: V
authors.initials: V
authors.lastname: Mitro
authors.forename: C
authors.initials: C
authors.lastname: Ungari
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D059266:Bisphosphonate-Associated Osteonecrosis of the Jaw / Q000188:drug therapy* / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D010126:Ozone / Q000627:therapeutic use*; D012189:Retrospective Studies
chemical_list: D000900:Anti-Bacterial Agents; D000935:Antifungal Agents; D010126:Ozone