Surgical Management of Bisphosphonate-related Osteonecrosis of the Jaws: Literature Review

Overview

Journal Oral Maxillofac Surg

Specialties Dentistry
General Surgery

Date 2015 Dec 15

PMID 26659615

Citations 16

Authors

Larissa Fernandes Silva

Claudia Curra

Marcelo Salles Munerato

Carlos Cesar Deantoni

Mariza Akemi Matsumoto

Camila Lopes Cardoso

Marcos Martins Curi

Affiliations

Soon will be listed here.

Abstract

Purpose: Surgical management of bisphosphonate-related osteonecrosis of the jaws (BRONJ) has been performed in an attempt to increase healing rates of the affected cases. This literature review aimed to identify clinical studies of surgical management of bisphosphonate-related osteonecrosis of the jaws (BRONJ) in order to assess their surgical treatment modalities, outcome and the follow-up.

Methods: A search in the PubMed (Medline) database using specific terms and/or phrases as "bisphosphonate-related osteonecrosis" or "jaw osteonecrosis", and "surgical treatment" or "surgical management" was conducted in order to identify clinical trials and cases of surgical treatment of BRONJ. The review search covered the time period from 2004 to 2014. All studies identified in the search were selected according to the inclusion criteria. Relevant information was recorded according to the following items: author, year, number of patients, BRONJ clinical stage, surgical treatment modality, clinical success, and follow-up.

Results: The initial database search yielded 345 titles. After filtering, 67 abstracts were selected culminating in 67 full text articles. A variety of surgical approach was found in this review: debridement, sequestrectomy bone resection, and bone reconstruction. Adjunctive therapies included hyperbaric oxygen, laser therapy, growth factors, and ozone.

Conclusion: Although there are many indexed studies about BRONJ, well-documented reports concerning surgical therapeutically techniques are scarce, resulting from a lack of well-established protocols. Considerable differences were found regarding sample size, surgical treatment modalities and outcomes. Clinical studies with larger number of patients and longer follow-up are required to provide best information for each surgical treatment modality and its outcomes.

Citing Articles

Promising results of surgical management of advanced medication related osteonecrosis of the jaws using adjunctive leukocyte and platelet rich fibrin.

Ozalp O, Yildirimyan N, Ozturk C, Kocabalkan B, Simsek Kaya G, Sindel A BMC Oral Health. 2021; 21(1):613.

PMID: 34852823 PMC: 8638116. DOI: 10.1186/s12903-021-01965-7.

Analysis of Factors Associated with the Postoperative Healing of Medication-Related Osteonecrosis of the Jaw in Patients with Osteoporosis.

Shim Y, Jung S, Boboeva O, Lee S, Kim J, Kwon T J Clin Med. 2021; 10(16).

PMID: 34441947 PMC: 8397037. DOI: 10.3390/jcm10163651.

Characteristics of patients with osteonecrosis of the jaw with oral versus intravenous bisphosphonate treatment.

Lee S, Choi S, Bae M, Kwon T Maxillofac Plast Reconstr Surg. 2021; 43(1):24.

PMID: 34236538 PMC: 8266939. DOI: 10.1186/s40902-021-00310-w.

Adipose-Derived Stem Cells Promote Bone Coupling in Bisphosphonate-Related Osteonecrosis of the Jaw by TGF-β1.

Dong X, He L, Zang X, He Y, An J, Wu B Front Cell Dev Biol. 2021; 9:639590.

PMID: 34055774 PMC: 8154543. DOI: 10.3389/fcell.2021.639590.

New Perspective for Soft Tissue Closure in Medication-Related Osteonecrosis of the Jaw (MRONJ) Using Barbed Sutures.

Laimer J, Hechenberger M, Lercher J, Born E, Schomaker M, Puntscher S J Clin Med. 2021; 10(8).

PMID: 33919696 PMC: 8069803. DOI: 10.3390/jcm10081677.

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