Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2014:2014:107690.
doi: 10.1155/2014/107690. Epub 2014 Feb 6.

Conservative surgical management of stage I bisphosphonate-related osteonecrosis of the jaw

Paolo Vescovi  1 , Elisabetta Merigo  1 , Marco Meleti  1 , Maddalena Manfredi  1 , Carlo Fornaini  1 , Samir Nammour  2 , Giovanni Mergoni  1 , Amin Sarraj  1 , Jose V Bagan  3
Affiliations

Conservative surgical management of stage I bisphosphonate-related osteonecrosis of the jaw

Paolo Vescovi et al. Int J Dent. 2014.

Abstract

Purpose. To report the efficacy of conservative surgical treatment for stage I bisphosphonate-related osteonecrosis of the jaw (BRONJ). Materials and Methods. This study reports the clinical outcomes of 63 patients treated for BRONJ stage I (according to Ruggiero's staging system) at the Oral Pathology and Laser-Assisted Surgery Unit of the University of Parma between January 2004 and January 2011. Surgical interventions were performed, under local analgesia, in patients unresponsive for a period of six months to noninvasive treatments such as cycles of local or systemic antibacterial therapy combined or not to low level laser therapy, ozone therapy, or Hyperbaric Oxygen Therapy. All interventions were performed after the consultation of oncologist or physician. Results. In our experience, conservative surgical treatment is associated with the highest number of BRONJ healed sites in stage I disease. Complete healing was observed in 92.6% of sites surgically treated. Conclusions. This study confirms that treatment of patients affected by minimal bone exposition, (stage I of BRONJ), through conservative surgical strategies, possibly with laser, may result in a high control of the disease in the long term.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Maxillary stage I BRONJ developed in a patient who received infusions of zoledronic acid for metastasis of a breast cancer. Successfull treatment with Er:YAG laser.
Figure 2
Figure 2
BRONJ on the left mylohyoid crest in a patient affected by multiple myeloma—complete healing achieved after Er:YAG surgery.
Figure 3
Figure 3
Left maxillar BRONJ stage I in a patient treated with zoledronic acid for brest cancer.
See this image and copyright information in PMC

References

    1. Landesberg R, Woo V, Cremers S, et al. Potential pathophysiological mechanisms in osteonecrosis of the jaw. Annals of the New York Academy of Sciences. 2011;1218(1):62–79. - PMC - PubMed
    1. Bagan J, Scully C, Sabater V, Jimenez Y. Osteonecrosis of the jaws in patients treated with intravenous bisphosphonates (BRONJ): a concise update. Oral Oncology. 2009;45(7):551–554. - PubMed
    1. Ruggiero SL, Dodson TB, Assael LA, Landesberg R, Marx RE, Mehrotra B. American association of oral and maxillofacial surgeons position paper on bisphosphonate-related osteonecrosis of the jaws—2009 update. Journal of Oral and Maxillofacial Surgery. 2009;67(5, supplement):2–12. - PubMed
    1. Vescovi P, Merigo E, Meleti M, Manfredi M. Early surgical approach preferable to medical therapy for bisphosphonate-related osteonecrosis of the jaws. Journal of Oral and Maxillofacial Surgery. 2008;66(4):831–832. - PubMed
    1. Bashutski JD, Eber RM, Kinney JS, et al. Teriparatide and osseous regeneration in the oral cavity. The New England Journal of Medicine. 2010;363(25):2396–2405. - PMC - PubMed

LinkOut - more resources