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.
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.
⁎Associate Professor and Residency Program Director, Department of Oral and Maxillofacial Surgery, University of Pennsylvania Health System and School of Dental Medicine, Philadelphia, PA
†Formerly, Chief Resident, University of Pennsylvania Health System and School of Dental Medicine, Philadelphia, PA; and Currently, Private Practice, Newport Beach, CA
Address 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
David C. Stanton is a consultant for a law firm, on behalf of Novartis, the manufacturer of Aredia and Zometa.
ABSTRACT