Biphosphonate-associated osteonecrosis can be controlled by nonsurgical management

Sixteen patients with jaw biphosphonate-osteonecrosis and with exposed bone areas were subdivided into 2 treatment groups. The first group (7 patients) underwent superficial or radical surgical therapy, while the second (9 patients) underwent antibiotic treatment. A slight reduction of the necrotic...

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Published in:Oral surgery, oral medicine, oral pathology, oral radiology and endodontics oral medicine, oral pathology, oral radiology and endodontics, 2007-10, Vol.104 (4), p.473-477
Main Authors: Montebugnoli, Lucio, MD, DDS, Felicetti, Laura, DDS, Gissi, Davide Bartolomeo, DDS, Pizzigallo, Angelo, MD, Pelliccioni, Gian Andrea, MD, DDS, Marchetti, Claudio, MD, DDS
Format: Article
Language:English
Subjects:
Aged
Amoxicillin-Potassium Clavulanate Combination - therapeutic use
Analysis of Variance
Anti-Bacterial Agents - therapeutic use
Biological and medical sciences
Bone Density Conservation Agents - adverse effects
Diphosphonates - adverse effects
Diseases of the osteoarticular system
Female
Humans
Imidazoles - adverse effects
Jaw Diseases - chemically induced
Jaw Diseases - drug therapy
Jaw Diseases - surgery
Linear Models
Male
Medical sciences
Metronidazole - therapeutic use
Middle Aged
Osteonecrosis - chemically induced
Osteonecrosis - drug therapy
Osteonecrosis - surgery
Otorhinolaryngology. Stomatology
Prospective Studies
Surgery
Vascular bone diseases
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Summary:Sixteen patients with jaw biphosphonate-osteonecrosis and with exposed bone areas were subdivided into 2 treatment groups. The first group (7 patients) underwent superficial or radical surgical therapy, while the second (9 patients) underwent antibiotic treatment. A slight reduction of the necrotic areas was observed in 5 of 7 patients in the first group, whereas no change was observed in the remaining 2 patients at 22- and 24-month follow-up. A slight reduction of the necrotic areas was observed in 7 of 9 patients in the second group, whereas no change was observed in the remaining 2 patients at 5- and 24-month follow-up. The statistical analysis showed that the treatment regimen did not significantly influence the dimensional change in the exposed bone. The preliminary results seem to suggest that biphosphonate-associated osteonecrosis can be well controlled by a nonsurgical protocol consisting in long-term administration of antibiotics.
ISSN:1079-2104
1528-395X
DOI:10.1016/j.tripleo.2007.01.008