Document Detail


Surgical management of bisphosphonate induced osteonecrosis of the jaws.
MedLine Citation:
PMID:  20015614     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Recent literature contains numerous articles on osteonecrosis of the jaws (ONJ) associated with bisphosphonate treatment (BPT), with most advocating a conservative approach to management. A prospective study was designed to review the surgical management of cases of ONJ that did not respond to conservative management. Forty patients, referred with ONJ that did not respond to conservative management, were treated surgically and followed up for 6 months to 4 years. Four patients were taking i.v. BPT as part of their bone cancer management and 16 were taking oral BPT for osteoporosis. The surgical management of ONJ involved antibiotic therapy, surgical debridement of all necrotic bone and tension-free primary closure. All 40 cases healed uneventfully with no wound breakdown during follow-up. Most of the literature supports the conservative management of ONJ, but the condition leaves the patient debilitated. Many cases do not respond to conservative management and the infection and bone destruction is progressive. The conservative management of ONJ is to be supported, but this prospective study has shown that those cases that do not respond may be managed surgically. It should be recognized that while the results of this paper are encouraging, some cases will be resistant to all treatments.
Authors:
R A Williamson
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2009-12-16
Journal Detail:
Title:  International journal of oral and maxillofacial surgery     Volume:  39     ISSN:  1399-0020     ISO Abbreviation:  Int J Oral Maxillofac Surg     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-03-08     Completed Date:  2010-06-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8605826     Medline TA:  Int J Oral Maxillofac Surg     Country:  Denmark    
Other Details:
Languages:  eng     Pagination:  251-5     Citation Subset:  D; IM    
Affiliation:
Department of Oral Surgery, Faculty of Medicine and Dentistry, University of Western Australia, 17 Monash Avenue, Perth, WA 6009, Australia. raymond.williamson@iinet.net.au <raymond.williamson@iinet.net.au>
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Amoxicillin / therapeutic use
Anti-Bacterial Agents / therapeutic use
Anti-Infective Agents, Local / therapeutic use
Bone Density Conservation Agents / adverse effects*
Bone Neoplasms / drug therapy
Chlorhexidine / therapeutic use
Clindamycin / therapeutic use
Debridement
Diphosphonates / adverse effects*
Disease Progression
Female
Follow-Up Studies
Humans
Jaw Diseases / chemically induced,  surgery*
Male
Middle Aged
Mouthwashes / therapeutic use
Multiple Myeloma / drug therapy
Osteonecrosis / chemically induced,  surgery*
Osteoporosis / drug therapy
Postoperative Complications
Prospective Studies
Surgical Flaps
Suture Techniques
Treatment Outcome
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents; 0/Anti-Infective Agents, Local; 0/Bone Density Conservation Agents; 0/Diphosphonates; 0/Mouthwashes; 18323-44-9/Clindamycin; 26787-78-0/Amoxicillin; 55-56-1/Chlorhexidine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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