title: Stage-related treatment concept of medication-related osteonecrosis of the jaw-a case series.
abstract: OBJECTIVE
  There is no general consensus for treatment of medication-related osteonecrosis of the jaw (MRONJ). A stage-related approach that primarily aims to minimize morbidity and preserve function was prospectively evaluated.
  
  
  METHODS
  Treatment goals are stable mucosal closure and absence of clinical symptoms. Patients were enrolled between March 2010 and October 2011. MRONJ lesions were treated either by conservative means or surgically by debridement or resective surgery.
  
  
  RESULTS
  In total, 38 patients were treated. Six patients were healed by undergoing conservative measures; nine were treated palliatively. Four patients dropped out after surgery in the recall phase. In 17 of 19 patients (89.5%) surgical treatment was successful. After a 1-year observation period, the success rate was 92% (23 of 25), including all patients treated as per protocol.
  
  
  CONCLUSIONS
  In stage-related treatment, conservative means or surgical debridement can be successful at early stages. Extensive resection is solely indicated in cases of extended necrosis.
  
  
  CONCLUSIONS
  The number of patients with MRONJ is steadily increasing. Guidelines to deal with this condition are helpful for both clinicians and dental practitioners.
authors.affiliation: Department of Oral Surgery and Radiology, Medical University of Graz, Graz, Austria, petra.rugani@medunigraz.at.
authors.forename: Petra
authors.initials: P
authors.lastname: Rugani
authors.forename: Stephan
authors.initials: S
authors.lastname: Acham
authors.forename: Barbara
authors.initials: B
authors.lastname: Kirnbauer
authors.forename: Astrid
authors.initials: A
authors.lastname: Truschnegg
authors.forename: Barbara
authors.initials: B
authors.lastname: Obermayer-Pietsch
authors.forename: Norbert
authors.initials: N
authors.lastname: Jakse
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001317:Austria; D059266:Bisphosphonate-Associated Osteonecrosis of the Jaw / Q000628:therapy*; D050071:Bone Density Conservation Agents / Q000009:adverse effects*; D000072700:Conservative Treatment; D003646:Debridement; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019647:Oral Surgical Procedures; D010166:Palliative Care; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D050071:Bone Density Conservation Agents