Maxillofacial Plastic and Reconstructive Surgery

Korean Association of Maxillofacial Plastic and Reconstructive Surgeons (대한악안면성형재건외과학회)
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Comparative Study on Surgical and Conservative Management of Bisphosphonate-related Osteonecrosis of the Jaw (BRONJ) in Disease Stage 2

비스포스포네이트 관련 악골괴사(BRONJ)의 병기 2기에서의 외과적, 보존적 치료에 대한 비교 연구

  • Lee, Ho Kyung (Division of Oral and Maxillofacial Surgery, Department of Dentistry, Ajou University School of Medicine) ;
  • Seo, Mi Hyun (Division of Oral and Maxillofacial Surgery, Department of Dentistry, Ajou University School of Medicine) ;
  • Pang, Kang Mi (Division of Oral and Maxillofacial Surgery, Department of Dentistry, Ajou University School of Medicine) ;
  • Song, Seung Il (Division of Oral and Maxillofacial Surgery, Department of Dentistry, Ajou University School of Medicine) ;
  • Lee, Jeong Keun (Division of Oral and Maxillofacial Surgery, Department of Dentistry, Ajou University School of Medicine)
  • 이호경 (아주대학교 의과대학 치과학교실 구강악안면외과) ;
  • 서미현 (아주대학교 의과대학 치과학교실 구강악안면외과) ;
  • 방강미 (아주대학교 의과대학 치과학교실 구강악안면외과) ;
  • 송승일 (아주대학교 의과대학 치과학교실 구강악안면외과) ;
  • 이정근 (아주대학교 의과대학 치과학교실 구강악안면외과)
  • Received : 2013.02.27
  • Accepted : 2013.09.21
  • Published : 2013.09.30
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Abstract

Purpose: This study evaluated the prognosis of conservative and surgical treatment according to the staging of bisphosphonate-related osteonecrosis of jaw (BRONJ) by American Association of Oral and Maxillofacial Surgeons and American Society for Bone and Mineral Research. Methods: We evaluated 53 patients of BRONJ who visited Department of Dentistry, Ajou University School of Medicine from May 2007 to February 2013. Twenty eight patients in stage 2, were divided into surgical and conservative groups with cessation of bisphosphonate therapy. Fifteen patients belonged to the conservative treatment group, in which mouth rinsing and antibiotics medication were done. Thirteen patients were treated with debridement or sequestrectomy, in the surgical treatment group. Each study list was analyzed by SPSS ver. 14.0 (SPSS Inc., USA) software and the favorable rate was verified by the Fisher exact test. P-values less than 0.05% were deemed significant. Results: Clinical outcome was evaluated on the basis of both clinical and radiographic findings. Of all the 28 patients of stage 2, 15 patients underwent conservative treatment and 13 patients received surgical treatment. In the surgical group, 9 of 13 (69.2%) showed good prognosis, 4 of 13 (30.7%) showed recurrence. In the conservative group, 13 of 15 (86.6%) showed no change duting the follow-up period. Two of 15 patients even showed a bad prognosis, such as pain and pus discharge, which are criteria for stage 3. P-value was 0.067 (>0.05). Conclusion: The results of the present study suggests that surgical intervention is good choice against the conservative treatment, after proper drug holidays period, while further investigation is needed for a definite solution to BRONJ.

Keywords

References

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