title: Modified protocol including topical minocycline in orabase to manage medication-related osteonecrosis of the jaw cases.
abstract: OBJECTIVE
  Management of medication-related osteone-crosis of the jaw (MRONJ) with active infection can be a serious challenge for clinicians. Based on Association of Oral and Maxillofacial Surgeons (AAOMS) recommendations, we have tested a modified treatment protocol using topical minocycline.
  
  
  METHODS
  Five patients diagnosed with stage II or III MRONJ lesions were willing to consent to our protocol. In addition to conventional treatment as suggested by the AAOMS, such as, surgical debridement, chlorhexidine irrigation, and systemic antibiotics, we applied 10% minocycline to the lesions once a week for sustained local antibiotic delivery.
  
  
  RESULTS
  All five patients reported pain relief after the first minocycline application. Complete healing occurred in three patients; case three healed completely after the third application, one case continues to improve toward resolution and one withdraws due to other non-relevant medical problem.
  
  
  CONCLUSIONS
  In this study, we are reporting favorable results using a modified protocol with topical minocycline to treat MRONJ lesions.
authors.affiliation: Department of Oral Medicine and Orofacial Pain, Division of Diagnostic Sciences, University of Southern California, Los Angeles, CA, USA. jumana2003@yahoo.com.
authors.forename: Jumana A
authors.initials: JA
authors.lastname: Karasneh
authors.affiliation: Department of Oral Medicine and Orofacial Pain, Division of Diagnostic Sciences, University of Southern California, Los Angeles, CA, USA.
authors.forename: Kamal
authors.initials: K
authors.lastname: Al-Eryani
authors.affiliation: Department of Oral Medicine and Orofacial Pain, Division of Diagnostic Sciences, University of Southern California, Los Angeles, CA, USA.
authors.forename: Glenn T
authors.initials: GT
authors.lastname: Clark
authors.affiliation: Centre for Biofilms, University of Southern California, Los Angeles, CA, USA.
authors.forename: Parish P
authors.initials: PP
authors.lastname: Sedghizadeh
mesh_terms: D000287:Administration, Topical; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D002266:Carboxymethylcellulose Sodium / Q000008:administration & dosage / Q000031:analogs & derivatives*; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007571:Jaw Diseases / Q000139:chemically induced / Q000188:drug therapy*; D008911:Minocycline / Q000008:administration & dosage*; D010020:Osteonecrosis / Q000139:chemically induced / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; C056627:Orabase; D008911:Minocycline; D002266:Carboxymethylcellulose Sodium
keywords: biofilm; bisphosphonate; medication-related osteonecrosis of the jaw; minocycline