Long-term success of surgery in bisphosphonate-related osteonecrosis of the jaws (BRONJs).

OBJECTIVES

Bisphosphonates are associated with osteonecrosis of the jaw. Bisphosphonate-related osteonecrosis of the jaw (BRONJ) may be treated conservatively or by surgery.

PATIENTS AND

METHODS

108 patients underwent surgery and 88 patients were followed for a mean period of 337 days. Age, gender, dental procedures, underlying disease, and the role of bisphosphonate treatment in the success of surgery were evaluated retrospectively.

RESULTS

Surgical treatment improved the stage distribution from 19% stage I, 56% stage II and 25% stage III to 59% intact mucosa, 19% stage I and 13% stage II and 8% stage III. The improvement in the stage of disease achieved by surgery was statistically significant. Further relevant parameters that favor a positive outcome of surgery were the event triggering the outbreak of BRONJ (p=0.05) and the underlying disease (p=0.05). BRONJ in the maxilla necessitated repeat surgery significantly earlier than did BRONJ in the mandible (p=0.03).

CONCLUSION

Effective surgery might improve the outcome of BRONJ, although prevention still is the most important aspect of this condition.