Adjuvant aqueous ozone in the treatment of bisphosphonate induced necrosis of the jaws: report of two cases and long-term follow-up.
Bisphosphonate induced necrosis of the jaws (BONJ) does not have a unique protocol of treatment and many therapeutic approaches have been arising in oral medicine with debatable results. A male and a female attended the University Oral Surgery Clinic presenting oral bone lesions induced by intravenous and oral bisphosphonates respectively as complications of dental extraction. Treatment included daily mouthwashes and weekly intra oral irrigations with 4 mg/L of aqueous-ozone, antibiotic therapy and sequential superficial debridment for sequestrectomies. Long-standing follow-ups showed complete mucosa covering of exposed bone area and resolution of purulent secretion. Antibacterial and antifungal properties of aqueous ozone may have played important roles in the treatment. The outcome measured intra oral examination and panoramic radiographs of the affected bone. The application of aqueous ozone daily mouthwashes and weekly professional irrigation were safe; free from adverse effects, easily of handling and worked as an important adjuvant therapeutic strategy for the treatment of BONJ.
Department of Oral Surgery Dental School, University of São Paulo Assistant Professor Oral Surgery São Leopoldo Mandic Dental School São Paulo, Brazil - mczdebon@usp.br.
M A
MA
Brozoski
C A
CA
Lemos
M
M
Da Graça Naclério-Homem
M C Z
MC
Deboni
D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000890:Anti-Infective Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage / Q000627:therapeutic use; D059266:Bisphosphonate-Associated Osteonecrosis of the Jaw / Q000188:drug therapy* / Q000601:surgery; D001859:Bone Neoplasms / Q000188:drug therapy / Q000556:secondary; D017024:Chemotherapy, Adjuvant; D002710:Chlorhexidine / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000627:therapeutic use; D002981:Clindamycin / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003646:Debridement; D004164:Diphosphonates / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007093:Imidazoles / Q000009:adverse effects / Q000627:therapeutic use; D008297:Male; D008336:Mandibular Diseases / Q000139:chemically induced / Q000188:drug therapy / Q000601:surgery; D008439:Maxillary Diseases / Q000139:chemically induced / Q000188:drug therapy / Q000601:surgery; D008875:Middle Aged; D009067:Mouthwashes; D015663:Osteoporosis, Postmenopausal / Q000188:drug therapy; D010126:Ozone / Q000008:administration & dosage / Q000627:therapeutic use*; D011471:Prostatic Neoplasms; D012995:Solubility; D000077211:Zoledronic Acid
D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents; D000891:Anti-Infective Agents, Local; D004164:Diphosphonates; D007093:Imidazoles; D009067:Mouthwashes; D002981:Clindamycin; D010126:Ozone; D000077211:Zoledronic Acid; C010882:chlorhexidine gluconate; D002710:Chlorhexidine