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. 2011 Feb;111(2):153-63.
doi: 10.1016/j.tripleo.2010.04.015. Epub 2010 Jul 31.

The role of surgical therapy in the management of intravenous bisphosphonates-related osteonecrosis of the jaw

Frank Wilde  1 , Marcus Heufelder, Karsten Winter, Jörg Hendricks, Bernhard Frerich, Alexander Schramm, Alexander Hemprich
Affiliations

The role of surgical therapy in the management of intravenous bisphosphonates-related osteonecrosis of the jaw

Frank Wilde et al. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011 Feb.

Abstract

Objectives: Bisphosphonate-related osteonecrosis of the jaw (BRONJ) seems resistant to conventional treatment approaches. We report a study with a surgical concept characterized by resection of the necrotic bone followed by sufficient wound closure.

Study design: In a clinical study of 24 patients with 33 sites of BRONJ, the surgical basis of the treatment was as follows: (1) conservative treatment with antimicrobiological rinsing, (2) resection of the entire necrotic bone and smoothening of any sharp bone edges, and (3) coverage of the remaining bone by use of a bilayered wound closure.

Results: In 88% of cases, BRONJ could be treated with success by use of this surgical therapy. Median follow-up was 60 weeks. There was no statistically significant difference between treatment results irrespective of whether or not bisphosphonate treatment was continued.

Conclusion: Because of the high success rate of this surgical technique it seems that patients with BRONJ may benefit from this approach.

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