title: Use of Ultrasonic Bone Surgery (Piezosurgery) to Surgically Treat Bisphosphonate-Related Osteonecrosis of the Jaws (BRONJ). A Case Series Report with at Least 1 Year of Follow-Up.
abstract: This preliminary work documents the use of a powerful piezosurgery device to treat biphosphonate-related osteonecrosis of the jaw (BRONJ) in combination with classical medication therapy. Eight patients presenting 9 BRONJ sites were treated, 2 in the maxilla and 7 in the mandible. Reason for biphosphonate (BiP) intake was treatment of an oncologic disease for 5 patients and osteoporosis for 3. The oncologic and osteoporosis patients were diagnosed with BRONJ after 35-110 months and 80-183 months of BiP treatment, respectively. BRONJ 2 and 3 was found in 4 patients. Resection of the bone sequestrae was performed with a high power ultrasonic (piezo) surgery and antibiotics were administrated for 2 weeks. Soft tissue healing was incomplete at the 2-week control but it was achieved within 1 month. At the 1-year control, soft tissue healing was maintained at all patients, without symptom recurrence. One patient with paraesthesia had abated; of the 2 pa-tients with trismus, one was healed, severity of the second trismus abated. This case report series suggests that bone resection performed with a high power ultrasonic surgery device combined with antibiotics might lead to BRONJ healing. More patients are warranted to confirm the present findings and assess this treatment approach.
authors.affiliation: OBL, Department of Surgical Sciences, University of Cagliari, Cagliari, Italy ; Private Practice, Torino, Italy.
authors.forename: Cornelio
authors.initials: C
authors.lastname: Blus
authors.forename: Serge
authors.initials: S
authors.lastname: Szmukler-Moncler
authors.forename: Giulio
authors.initials: G
authors.lastname: Giannelli
authors.forename: Gloria
authors.initials: G
authors.lastname: Denotti
authors.forename: Germano
authors.initials: G
authors.lastname: Orrù
keywords: BRONJ; Biofilm; Bisphosphonates; Bone infection; ONJ.; Osteonecrosis; Piezosurgery; Ultrasonic bone surgery
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