| Surgical management of bisphosphonate induced osteonecrosis of the jaws. | |
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MedLine Citation:
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PMID: 20015614 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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R A Williamson |
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Publication Detail:
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Type: Case Reports; Journal Article Date: 2009-12-16 |
Journal Detail:
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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:
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Created Date: 2010-03-08 Completed Date: 2010-06-10 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8605826 Medline TA: Int J Oral Maxillofac Surg Country: Denmark |
Other Details:
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Languages: eng Pagination: 251-5 Citation Subset: D; IM |
Affiliation:
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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> |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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:
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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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