Conservative surgical management of patients with bisphosphonate-related osteonecrosis of the jaws: a series of 120 patients

Nisi, Marco; Ferla, Fabio; Karapetsa, Dimitra; Gennai, Stefano; Ramaglia, Luca; Graziani, Filippo; Gabriele, Mario

doi:10.1016/j.bjoms.2016.06.015

Cited by 40 publications

(40 citation statements)

References 12 publications

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“…There is no consensus regarding the most appropriate treatment strategy for MRONJ, with disagreement between whether surgical or nonsurgical treatment should be recommended (Table ) . The AAOMS reports that the treatment objectives for patients with MRONJ are to eliminate pain, control infection of the soft tissue, and minimize the progression or occurrence of bone necrosis, and they recommend nonsurgical treatment .…”

Section: Discussionmentioning

confidence: 99%

“…The Japanese position paper on BRONJ recommended nonsurgical treatment for patients with BRONJ; other investigators have also recommended conservative treatment for MRONJ . In contrast, others have stated that surgical treatment is superior to conservative treatment; recently, some systematic reviews have also suggested that surgical treatment is more effective than nonsurgical treatment in patients with MRONJ . However, there have been no randomized controlled studies investigating whether nonsurgical or surgical treatment provides the best treatment outcome.…”

Section: Discussionmentioning

confidence: 99%

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Evaluation of the Treatment Strategies for Medication-Related Osteonecrosis of the Jaws (MRONJ) and the Factors Affecting Treatment Outcome: A Multicenter Retrospective Study with Propensity Score Matching Analysis

Hayashida

Soutome

Yanamoto

et al. 2017

Journal of Bone and Mineral Research

153

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Medication-related osteonecrosis of the jaw (MRONJ) is an adverse event that may inhibit the treatment of primary disease and remarkably influence the patient's quality of life. The treatment methods for MRONJ, nonsurgical and surgical, are controversial, with no agreement as to which method provides the best outcome and should therefore be recommended. This multicenter retrospective study aimed to investigate the treatment methods and outcome in a large number of patients with MRONJ in Japan, utilizing propensity score matching analysis. A total of 361 patients with MRONJ, at eight hospitals, were registered in this study retrospectively. Various demographic and treatment-related variables were examined and analyzed to determine their correlation with the treatment outcome. After propensity score matching for treatment methods (nonsurgical versus surgical treatment), 176 patients were analyzed by logistic regression. It was shown that those with low-dose administration of an antiresorptive agent and surgical treatment had better outcomes. Furthermore, in 159 patients who underwent surgical treatment, those who underwent extensive surgery experienced significantly better treatment outcomes than those who underwent conservative surgery. This is the first study to compare treatment methods for MRONJ using propensity score matching analysis. The results indicated that extensive surgical treatment should be performed as first-choice therapy for patients with MRONJ. © 2017 American Society for Bone and Mineral Research.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Evaluation of the Treatment Strategies for Medication-Related Osteonecrosis of the Jaws (MRONJ) and the Factors Affecting Treatment Outcome: A Multicenter Retrospective Study with Propensity Score Matching Analysis

Hayashida

Soutome

Yanamoto

et al. 2017

Journal of Bone and Mineral Research

153

View full text Add to dashboard Cite

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“…In contrast, periosteal vascularity is mostly intact in MRONJ patients. The difference in periosteal vascularity probably influences the treatment outcome (i.e., the outcome of conservative surgical management is better in MRONJ, whereas minimal debridement for ORN often fails) [7,18]. An important and well-known patient factor is age.…”

Section: Discussionmentioning

confidence: 99%

Differences between osteoradionecrosis and medication-related osteonecrosis of the jaw

Akashi

Wanifuchi

Iwata

et al. 2017

Oral Maxillofac Surg

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“…In the past, the surgical treatments were reserved only for advanced stages of BRONJ; the Italian Society of Oral and Maxillofacial Surgery (SICMF) and the Italian Society of Oral Pathology and Medicine (SIPMO) in 2012 recommended conservative surgery in lesions belonging to stages I and II, as defined by both societies, that can provide resolution of acute infection and offers long-term of well-being for patients [10, 11, 13–17]. …”

Section: Introductionmentioning

confidence: 99%

Conservative Surgical Treatment of Bisphosphonate-Related Osteonecrosis of the Jaw with Er,Cr:YSGG Laser and Platelet-Rich Plasma: A Longitudinal Study

Mauceri

Panzarella

Maniscalco

et al. 2018

BioMed Research International

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Introduction The management of bisphosphonate-related osteonecrosis of the jaw (BRONJ), with no evidence-based guidelines, remains controversial. We aimed to evaluate the efficiency of a conservative surgical treatment combining Er,Cr:YSGG laser and platelet-rich plasma (PRP) for the treatment of BRONJ in cancer patients. Methods We performed a longitudinal cohort study. Inclusion criteria were (1) age ≥ 18 years; (2) cancer diagnosis; (3) treatment with NBP because of the underlying cancer. Results We consecutively recruited ten patients diagnosed with BRONJ in stage I or II. These patients underwent a surgical laser-assisted therapy together with autologous PRP. At the latest follow-up at 12 months, clinical improvement was observed in eight patients. Registration Number is IRCT20180329039159N1. Conclusion We could successfully manage the BRONJ utilizing this combined protocol to heal the 30% of surgically treated sites and to improve the 50% of patients' lesions clinically. Our findings suggest that a surgical approach combined with Er,Cr:YSGG laser and PRP benefit cancer patients with general health issues.

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Conservative surgical management of patients with bisphosphonate-related osteonecrosis of the jaws: a series of 120 patients

Cited by 40 publications

References 12 publications

Evaluation of the Treatment Strategies for Medication-Related Osteonecrosis of the Jaws (MRONJ) and the Factors Affecting Treatment Outcome: A Multicenter Retrospective Study with Propensity Score Matching Analysis

Evaluation of the Treatment Strategies for Medication-Related Osteonecrosis of the Jaws (MRONJ) and the Factors Affecting Treatment Outcome: A Multicenter Retrospective Study with Propensity Score Matching Analysis

Differences between osteoradionecrosis and medication-related osteonecrosis of the jaw

Conservative Surgical Treatment of Bisphosphonate-Related Osteonecrosis of the Jaw with Er,Cr:YSGG Laser and Platelet-Rich Plasma: A Longitudinal Study

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