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Int J Oral Maxillofac Surg. 2012 Nov;41(11):1404-9. doi: 10.1016/j.ijom.2012.05.012. Epub 2012 Jun 14.

The outcomes of conservative and surgical treatment of stage 2 bisphosphonate-related osteonecrosis of the jaws: a case series.

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Division of Restorative Dentistry, Faculty of Dentistry, McGill University, Montreal, QC, Canada.


The purpose of the current retrospective chart review is to describe the outcomes of conservative or surgical treatment of stage 2 bisphosphonate-related osteonecrosis of the jaws (BRONJ). 14 charts (mean patient age 69.07 ± 10.37 years) describing 19 BRONJ stage 2 sites were identified. According to the treatment protocol, all patients received conservative treatment. Surgical treatment was delivered only to sites that did not respond to conservative treatment. Conservative treatment alone was delivered to 11 sites in 8 patients (mean postoperative follow-up 17.6 ± 9.4 months). Surgical treatment was delivered to 8 sites in 6 patients (mean postoperative follow-up 10.0 ± 6.1 months). Bisphosphonate exposure ranged from 1 to 8 years. In most cases, tooth extractions and wearing dentures were reported as triggers for BRONJ. At the last follow-up, BRONJ stage 0 was noted in 7 sites that received conservative treatment and 5 sites that received surgical treatment. Within the limitations of the current chart review, the results showed that although conservative treatment for BRONJ stage 2 can provide favourable outcomes, surgical treatment represents a suitable alternative in non-responsive cases.

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