6533b82cfe1ef96bd12901b4
RESEARCH PRODUCT
Resective surgical approach shows a high performance in the management of advanced cases of bisphosphonate-related osteonecrosis of the jaws: a retrospective survey of 347 cases
Mario GabrieleMario MiccoliStefano GennaiFranco PelusoGiuseppina CampisiFilippo GrazianiGiovanni Maria GaetaGiuseppe ColellaPaolo VescoviFranco GoiaGianfranco FaviaMatteo ScolettaLuigi Solazzosubject
AdultMalemedicine.medical_specialtyMultivariate analysismedicine.medical_treatmentLogistic regressionSettore MED/28 - Malattie OdontostomatologicheHumansMedicinebisphosphonate-related osteonecrosis of the jawsAgedRetrospective StudiesAnalysis of VarianceUnivariate analysisChi-Square Distributionbusiness.industryRetrospective cohort studyPerioperativeMiddle AgedBisphosphonatemedicine.diseaseOsteotomySurgeryTreatment OutcomeDebridementItalyOtorhinolaryngologySurgical Procedures OperativeTooth ExtractionRegression AnalysisBisphosphonate-Associated Osteonecrosis of the JawFemaleSurgeryOral SurgerybusinessOsteonecrosis of the jawChi-squared distributiondescription
Abstract PURPOSE: The aim of this study was to evaluate the results of the surgical treatment of bisphosphonate-related osteonecrosis of the jaw (BRONJ) in a large cohort. MATERIALS AND METHODS: A retrospective cohort multicenter study was designed. Patients were enrolled if they were diagnosed with BRONJ and received operative treatment. Data on demographic, health status, perioperative, and surgical factors were collected retrospectively. The primary outcome variable was a change in BRONJ staging (improvement, worsening, or no change). Interventions were grouped by local debridement and resective surgery. Data were collected for other variables as cofactors. Univariate analysis and logistic regressions were then performed. RESULTS: Of the 347 BRONJ-affected subjects, 59% showed improvement, 30% showed no change, and 11% showed worsening. Improvement was observed in 49% of cases treated with local debridement and 68% of cases treated with resective surgery. Multivariate analysis indicated that maxillary location, resective surgery, and no additional corticosteroid treatment were associated with a positive outcome. CONCLUSIONS: Surgical treatment of BRONJ appeared to be more effective when resective procedures were performed. Nonetheless, other factors, such as the absence of symptoms and the types of drug administration, should be taken into account before clinical decisions are made.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2012-11-01 |