Surgical management of bisphosphonate-related osteonecrosis of the jaw stages II and III.

Autor: Bodem JP; Department of Oral and Maxillofacial Surgery, University Hospital Heidelberg, Heidelberg, Germany., Schaal C; Department of Oral and Maxillofacial Surgery, University Hospital Heidelberg, Heidelberg, Germany., Kargus S; Department of Oral and Maxillofacial Surgery, University Hospital Heidelberg, Heidelberg, Germany., Saure D; Institute of Medical Biometry and Informatics, University of Heidelberg, Germany., Mertens C; Department of Oral and Maxillofacial Surgery, University Hospital Heidelberg, Heidelberg, Germany., Engel M; Department of Oral and Maxillofacial Surgery, University Hospital Heidelberg, Heidelberg, Germany., Hoffmann J; Department of Oral and Maxillofacial Surgery, University Hospital Heidelberg, Heidelberg, Germany., Freudlsperger C; Department of Oral and Maxillofacial Surgery, University Hospital Heidelberg, Heidelberg, Germany. Electronic address: chr.freudlsperger@med.uni-heidelberg.de.
Jazyk: angličtina
Zdroj: Oral surgery, oral medicine, oral pathology and oral radiology [Oral Surg Oral Med Oral Pathol Oral Radiol] 2016 Apr; Vol. 121 (4), pp. 367-72. Date of Electronic Publication: 2015 Dec 01.
DOI: 10.1016/j.oooo.2015.10.033
Abstrakt: Objective: The value of surgery in advanced stages of bisphosphonate-related osteonecrosis of the jaw (BRONJ) is still controversial. Hence, we evaluated the effect of surgical therapy in BRONJ stages II and III in combination with a standardized perioperative adjuvant treatment.
Study Design: We included 39 patients who presented with BRONJ in a total of 47 locations and stages II (n = 23) and III (n = 24). All patients had exclusively received a monthly intravenous application of zoledronic acid. Surgical therapy consisted of complete removal of the necrotic jaw, accompanied by a standardized perioperative adjuvant treatment including intravenous antibiotic prophylaxis, gastric feeding, and an antimicrobiologic mouth rinsing.
Results: Overall, 35 (74.5%) of the 47 BRONJ sites were treated successfully, with success defined as complete mucosal healing of the exposed jaw (n = 24) or as relative healing when surgical therapy downscaled BRONJ II or III to asymptomatic BRONJ stage I (n = 11). Interestingly, perioperative adjuvant treatment or bisphosphonate therapy parameters showed no statistical effect on the treatment outcome.
Conclusions: The results of the present study prove the effectiveness of surgical therapy for BRONJ stage II or III.
(Copyright © 2016 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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