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Usability of surgical treatment in cases of bisphosphonate-related osteonecrosis of the jaw stage 2 with sequestrum.

Fukushima Y, Enoki Y, Nakaoka C, Okubo M, Kokabu S, Nojima J, Sato T, Yoda T - Ann Maxillofac Surg (2015 Jan-Jun)

Bottom Line: Patient characteristics, frequency of inciting factors of osteonecrosis, and treatment results were compared between BRONJ group and non-BRONJ groups.Patient characteristics, frequency of inciting factors of osteonecrosis, and treatment results showed no significant differences between the two groups.No significant difference was found in correlation between the administration route of BPs and treatment results in the BRONJ group.

View Article: PubMed Central - PubMed

Affiliation: Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Saitama Medical University, Saitama, 350-0495, Japan.

ABSTRACT

Objective: This retrospective study was conducted to reveal usability of surgical treatment in the cases of bisphosphonate-related osteonecrosis of the jaw (BRONJ) stage 2 with sequestrum.

Patients and methods: Study subjects included 18 patients having BRONJ stage 2 with sequestrum and 12 non-BRONJ patients with nearly equal clinical states of BRONJ stage 2. Patient characteristics, frequency of inciting factors of osteonecrosis, and treatment results were compared between BRONJ group and non-BRONJ groups. In addition, correlation between treatment methods (conservative therapy, sequestrum curettage, and sequestrectomy) and treatment results and correlation between the administration route of bisphosphonates (BPs) (oral or intravenous) and treatment results were examined statistically. The Student's t-test and Fisher's exact test were performed for statistical analysis.

Results: Patient characteristics, frequency of inciting factors of osteonecrosis, and treatment results showed no significant differences between the two groups. In the BRONJ group, treatment result of sequestrectomy was significantly better than conservative therapy/sequestrum curettage (P < 0.001), however, no significant difference was observed in the non-BRONJ group. No significant difference was found in correlation between the administration route of BPs and treatment results in the BRONJ group.

Conclusion: Treatment outcome of sequestrectomy was better than conservative therapy/sequestrum curettage in BRONJ stage 2 cases with sequestrum.

No MeSH data available.


Related in: MedlinePlus

Sequestrum curettage (a) Nonbisphosphonate-related osteonecrosis of the jaw case with inseparate sequestrum (b) Curettage with cutting instrument
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Figure 1: Sequestrum curettage (a) Nonbisphosphonate-related osteonecrosis of the jaw case with inseparate sequestrum (b) Curettage with cutting instrument

Mentions: Regarding the inciting factors of osteonecrosis, ten cases in the BRONJ group were caused by tooth extraction, 8 cases were caused by other conditions (5 marginal periodontitis, 2 apical periodontitis, and 1 denture stomatitis). Seven cases in the non-BRONJ group were caused by tooth extraction, 5 cases were caused by other conditions (2 marginal periodontitis, 2 apical periodontitis, and 1 pericoronitis). Regarding the treatment method, conservative therapy (n = 3), sequestrum curettage (n = 6), and sequestrectomy (n = 9) were performed in the BRONJ group. Conservative therapy (n = 4), sequestrum curettage (n = 7), and sequestrectomy (n = 1) were performed in the non-BRONJ group. In this study, a treatment method which abrades the surface layer of inseparate sequestrum was defined as sequestrum curettage [Figure 1]. And a treatment method which removes separated sequestrum from normal bone with entire closed wound was defined as sequestrectomy [Figure 2]. In this study, all the cases with sequestrectomy were osteonecrosis cases had separated sequestrum in computed tomography.


Usability of surgical treatment in cases of bisphosphonate-related osteonecrosis of the jaw stage 2 with sequestrum.

Fukushima Y, Enoki Y, Nakaoka C, Okubo M, Kokabu S, Nojima J, Sato T, Yoda T - Ann Maxillofac Surg (2015 Jan-Jun)

Sequestrum curettage (a) Nonbisphosphonate-related osteonecrosis of the jaw case with inseparate sequestrum (b) Curettage with cutting instrument
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4555952&req=5

Figure 1: Sequestrum curettage (a) Nonbisphosphonate-related osteonecrosis of the jaw case with inseparate sequestrum (b) Curettage with cutting instrument
Mentions: Regarding the inciting factors of osteonecrosis, ten cases in the BRONJ group were caused by tooth extraction, 8 cases were caused by other conditions (5 marginal periodontitis, 2 apical periodontitis, and 1 denture stomatitis). Seven cases in the non-BRONJ group were caused by tooth extraction, 5 cases were caused by other conditions (2 marginal periodontitis, 2 apical periodontitis, and 1 pericoronitis). Regarding the treatment method, conservative therapy (n = 3), sequestrum curettage (n = 6), and sequestrectomy (n = 9) were performed in the BRONJ group. Conservative therapy (n = 4), sequestrum curettage (n = 7), and sequestrectomy (n = 1) were performed in the non-BRONJ group. In this study, a treatment method which abrades the surface layer of inseparate sequestrum was defined as sequestrum curettage [Figure 1]. And a treatment method which removes separated sequestrum from normal bone with entire closed wound was defined as sequestrectomy [Figure 2]. In this study, all the cases with sequestrectomy were osteonecrosis cases had separated sequestrum in computed tomography.

Bottom Line: Patient characteristics, frequency of inciting factors of osteonecrosis, and treatment results were compared between BRONJ group and non-BRONJ groups.Patient characteristics, frequency of inciting factors of osteonecrosis, and treatment results showed no significant differences between the two groups.No significant difference was found in correlation between the administration route of BPs and treatment results in the BRONJ group.

View Article: PubMed Central - PubMed

Affiliation: Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Saitama Medical University, Saitama, 350-0495, Japan.

ABSTRACT

Objective: This retrospective study was conducted to reveal usability of surgical treatment in the cases of bisphosphonate-related osteonecrosis of the jaw (BRONJ) stage 2 with sequestrum.

Patients and methods: Study subjects included 18 patients having BRONJ stage 2 with sequestrum and 12 non-BRONJ patients with nearly equal clinical states of BRONJ stage 2. Patient characteristics, frequency of inciting factors of osteonecrosis, and treatment results were compared between BRONJ group and non-BRONJ groups. In addition, correlation between treatment methods (conservative therapy, sequestrum curettage, and sequestrectomy) and treatment results and correlation between the administration route of bisphosphonates (BPs) (oral or intravenous) and treatment results were examined statistically. The Student's t-test and Fisher's exact test were performed for statistical analysis.

Results: Patient characteristics, frequency of inciting factors of osteonecrosis, and treatment results showed no significant differences between the two groups. In the BRONJ group, treatment result of sequestrectomy was significantly better than conservative therapy/sequestrum curettage (P < 0.001), however, no significant difference was observed in the non-BRONJ group. No significant difference was found in correlation between the administration route of BPs and treatment results in the BRONJ group.

Conclusion: Treatment outcome of sequestrectomy was better than conservative therapy/sequestrum curettage in BRONJ stage 2 cases with sequestrum.

No MeSH data available.


Related in: MedlinePlus