Comparative Study on Surgical and Conservative Management of Bisphosphonate-Related Osteonecrosis of the Jaw (BRONJ)
Jeong Keun LEE*, Yoon Ho KIM, Ho Kyeong LEE
Oral and Maxillofacial surgery, Department of Dentistry, Ajou University School of Medicine
Purpose:This study evaluated the prognosis of conservative and surgical treatment of BRONJ
Methods: We evaluated 54 patients of BRONJ who visited Department of Dentistry, Ajou University School of Medicine from May 2007 to September 2013, which was divided into surgical and conservative group with cessation of bisphosphonate therapy. Thirty four patients belonged to conservative treatment group, in which mouth rinsing and antibiotics medication were done. Twenty patients were treated with debridement or sequestrectomy, which group was the surgical treatment group. Each group was analyzed by SPSS (version 17.0, SPSS Inc., USA) software and the favorable rate was verified by T-test. P values less than 0.05% were deemed significant.
Results:Clinical outcome was evaluated on the basis of both clinical and radiographic findings. In surgical treatment group, 11 of 20 (55%) showed good prognosis, whereas 9 of 20 (45%) showed recurrence. In conservative management group, 32 of 34 (94.1%) showed no change duting follow-up period. Two of 34 patients even showed bad prognosis such as pain and pus discharge. P value was 0.006(<0.05).
Conclusion:The results of present study suggests that surgical intervention is good choice against the conservative treatment, after proper period of drug holiday.
References
1. Board of Bone Bank, Korean Association of Oral and Maxillofacial Surgeons. Bisphosphonates-related osteonecrosis of the jaw in Korea: a preliminary report. J Korean Assoc Oral Maxillofac Surg 2013;39:9-13.
2. LEE HK et al. Comparative study on surgical and conservative management of bisphosphonate-related osteonecrosis of the jaw (BRONJ) in disease stage 2. J Korean Assoc Maxillofac Plast Reconstr Surg 2013;35(5):302-309.
3. Lee JK. Dental Considerations of the Bisphosphonate-related Osteonecrosis of the Jaw. Osteoporosis Vol.9 No.1 April 2011:18-27.
4. American Association of Oral and Maxillofacial Surgeons. Position paper on bisphosphonate-related osteonecrosis of the jaw-2009 update. J Oral Maxillofac Surg 2009;67:2-12.