Treatment outcomes in patients with bisphosphonate-related osteonecrosis of the jaws: a prospective study

Objectives. The aim of this study was to evaluate the 2-year success rate of management of patients with bisphosphonate-related osteonecrosis of the jaws (BRONJ). Study design. A prospective study was performed. Positive outcome variables were the resolution of symptoms and the status of the mucosa. Results. A total of 37 patients are described. The precipitating event was a dental extraction in 22 cases (59.5%). Thirteen patients (35.1%) underwent surgery, and 24 (64.9%) underwent antimicrobial therapy alone. After 2 years, 20 patients (54.1%) presented with soft tissue closure over previously exposed bone, and there were no statistical differences in gender, age, bisphosphonate treatment, or treatment modalities. Spontaneous lesions seemed to have a worse prognosis (P = .001). Conclusions. Initial antimicrobial treatment, and later surgery for unresponsive patients, might be a feasible treatment modality for BRONJ. Because these results are not conclusive, it would be very interesting to know if this statement would be the same with a greater number of patients. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010; 110: 46-53)