alexa The role of surgical resection in the management of bisphosphonate-related osteonecrosis of the jaws.
Surgery

Surgery

Surgery: Current Research

Author(s): Carlson ER, Basile JD

Abstract Share this page

Abstract PURPOSE: Bisphosphonate-related osteonecrosis of the jaws (BRONJ) is a poorly understood pathologic entity from the standpoints of its nomenclature, frequency, pathogenesis, and best method of treatment. In particular, numerous recommendations have been made for treatment involving nonsurgical therapy. It is the purpose of this article to specifically examine the success of resection of the necrotic bone in the mandible and maxilla in these patients. PATIENTS AND METHODS: We identified 103 sites of BRONJ in 82 patients. Of these sites of osteonecrosis, 32 were in the maxilla and 71 were in the mandible. Of the patients, 30 were taking an oral bisphosphonate medication whereas 52 were taking a parenteral bisphosphonate medication. Resection was performed in 95 sites of osteonecrosis in 74 patients, whereas 8 sites diagnosed in 8 patients were not resected. A total of 27 sites of BRONJ were resected in patients treated with oral bisphosphonates, and 68 sites of BRONJ were resected in patients treated with parenteral bisphosphonates. RESULTS: Of the 95 resected sites, 87 (91.6\%) healed in an acceptable fashion with resolution of disease. Of 27 resected sites in patients taking an oral bisphosphonate medication, 26 (96.3\%) healed satisfactorily, with refractory disease developing in 1 site. Of 68 resected sites in patients taking a parenteral bisphosphonate medication, 61 (89.7\%) healed satisfactorily, with refractory disease developing in 7 sites. All 29 patients (100\%) undergoing resection of the maxilla related to either an oral or parenteral bisphosphonate healed acceptably. The 8 patients who had the development of refractory disease did so with a range of 7 to 250 days postoperatively (mean, 73 days). Of the 8 sites of refractory disease, 6 developed after a marginal resection of the mandible for BRONJ. Three sites of new primary disease developed in 2 patients postoperatively. Both patients were taking a parenteral bisphosphonate medication. Histologic examination of the resected specimens identified malignant disease in 4 specimens in 3 patients. CONCLUSION: Resection of BRONJ permits acceptable healing in patients taking an oral bisphosphonate medication. In addition, resection of BRONJ of the maxilla in patients taking an oral or parenteral bisphosphonate medication follows a predictable course with regard to healing. Resection of BRONJ of the mandible in patients taking a parenteral bisphosphonate medication follows a variable postoperative course, although a high degree of success is realized. Surgeons should consider resection of necrotic bone of the maxilla and mandible that develops in patients taking bisphosphonate medications. In addition, refractory disease can be successfully managed with a more aggressive resection, specifically, a segmental resection of the mandible after a marginal resection of the mandible where refractory disease developed. This article was published in J Oral Maxillofac Surg and referenced in Surgery: Current Research

Relevant Expert PPTs

Relevant Speaker PPTs

Recommended Conferences

  • Global surgeons meeting on Bariatric surgery
    October 30-November 1, 2017,San Antonio,USA
  • International Conference on Bariatric surgery
    March 15-16, 2018, Barcelona, Spain

Relevant Topics

Peer Reviewed Journals
 
Make the best use of Scientific Research and information from our 700 + peer reviewed, Open Access Journals
International Conferences 2017-18
 
Meet Inspiring Speakers and Experts at our 3000+ Global Annual Meetings

Contact Us

Agri, Food, Aqua and Veterinary Science Journals

Dr. Krish

[email protected]

1-702-714-7001 Extn: 9040

Clinical and Biochemistry Journals

Datta A

[email protected]

1-702-714-7001Extn: 9037

Business & Management Journals

Ronald

[email protected]

1-702-714-7001Extn: 9042

Chemical Engineering and Chemistry Journals

Gabriel Shaw

[email protected]

1-702-714-7001 Extn: 9040

Earth & Environmental Sciences

Katie Wilson

[email protected]

1-702-714-7001Extn: 9042

Engineering Journals

James Franklin

[email protected]

1-702-714-7001Extn: 9042

General Science and Health care Journals

Andrea Jason

[email protected]

1-702-714-7001Extn: 9043

Genetics and Molecular Biology Journals

Anna Melissa

[email protected]

1-702-714-7001 Extn: 9006

Immunology & Microbiology Journals

David Gorantl

[email protected]

1-702-714-7001Extn: 9014

Informatics Journals

Stephanie Skinner

[email protected]

1-702-714-7001Extn: 9039

Material Sciences Journals

Rachle Green

[email protected]

1-702-714-7001Extn: 9039

Mathematics and Physics Journals

Jim Willison

[email protected]

1-702-714-7001 Extn: 9042

Medical Journals

Nimmi Anna

[email protected]

1-702-714-7001 Extn: 9038

Neuroscience & Psychology Journals

Nathan T

[email protected]

1-702-714-7001Extn: 9041

Pharmaceutical Sciences Journals

John Behannon

[email protected]

1-702-714-7001Extn: 9007

Social & Political Science Journals

Steve Harry

[email protected]

1-702-714-7001 Extn: 9042

 
© 2008-2017 OMICS International - Open Access Publisher. Best viewed in Mozilla Firefox | Google Chrome | Above IE 7.0 version
adwords