Journal of Oral and Maxillofacial Surgery
Volume 67, Issue 5 , Pages 943-950, May 2009

Outcome of Surgical Management of Bisphosphonate-Related Osteonecrosis of the Jaws: Review of 33 Surgical Cases

A part of these data were presented in preliminary abstract form at the American Association of Oral and Maxillofacial Surgeons 88th Annual Meeting, San Diego, CA.

  • David C. Stanton, DMD, MD

      Affiliations

    • Associate Professor and Residency Program Director, Department of Oral and Maxillofacial Surgery, University of Pennsylvania Health System and School of Dental Medicine, Philadelphia, PA
    • Corresponding Author InformationAddress correspondence and reprint requests to Dr Stanton: Department of Oral and Maxillofacial Surgery, University of Pennsylvania School of Medicine, 3400 Spruce Street, 5th Floor, White Building, Philadelphia, PA 19104
    • ,
  • Edward Balasanian, DDS, MD

      Affiliations

    • Formerly, Chief Resident, University of Pennsylvania Health System and School of Dental Medicine, Philadelphia, PA; and Currently, Private Practice, Newport Beach, CA

Purpose

We describe our experience with surgical management of bisphosphonate-related osteonecrosis of the jaws (BRONJ).

Materials and Methods

The data included 33 BRONJ cases treated surgically by a single surgeon at the Hospital of the University of Pennsylvania.

Results

Of the 30 debridement patients, 25 (including 1 sequestrectomy patient who required formal debridement) healed completely. Of the 30 patients who underwent surgical debridement, 18 healed following this initial treatment and remained healed. Of the 4 patients requiring sequestrectomy, 3 healed after the initial treatment. Thus, 28 of 33 patients healed completely with complete mucosal coverage and elimination of pain. Four patients developed occurrence of BRONJ at a separate site. All 4 patients were treated with our surgery protocol and remain healed. Thus, 32 of 37 BRONJ occurrences have healed with our surgical debridement protocol or sequestrectomy. The follow-up range was 1 to 40 months (average 10.7).

Conclusions

The results of our case series have shown that surgical debridement can be successful in treating BRONJ.

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 David C. Stanton is a consultant for a law firm, on behalf of Novartis, the manufacturer of Aredia and Zometa.

PII: S0278-2391(09)00116-5

doi:10.1016/j.joms.2008.12.057

Journal of Oral and Maxillofacial Surgery
Volume 67, Issue 5 , Pages 943-950, May 2009

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