Ozone Therapy in the Treatment of Avascular Bisphosphonate-Related Jaw Osteonecrosis

Abstract

Avascular osteonecrosis of the jaw (ONJ) may occur as a consequence of several conditions, even including chemotherapy treatment in patients affected by tumors or osteoporosis. We report our clinical experience in treating bisphosphonate-induced ONJ with a therapeutic methodology that includes ozone therapy as a new and original approach for the clinical management of maxillary necrotic lesions. Of 58 patients with ONJ observed at our department, 33 gave their informed consent to be part of the research and were treated according to a therapeutic approach, which included noninvasive surgery associated with pre- and postsurgical cycles of ozone therapy consisting of eight sessions lasting 3 minutes each besides antibiotic and antifungal therapies. Outcomes showed how ozone therapy increases the benefits of surgical and pharmacologic treatments, increasing the complete healing of the lesions with the disappearance of symptoms and brings cases of lesion progression down to zero. In conclusion, ozone therapy is a reliable presidium in treatment of ONJ; its benefits are remarkable and improve significantly the outcomes of the surgical approach.

Effects of Gaseous Ozone Treatment on Bone Regeneration in Femoral Defect Model in Rats

“…We demonstrated that bone regeneration are improved in the treatment group. Some authors recommend that ozone therapy may be beneficial in the treatment of bisphosphonate-induced bone necrosis or in extractive sites during and after in oral surgery because it might stimulate cell proliferation and soft tissue healing 19) . Recently, ozone has been used in several study on bone healing due to its immunomodulatory effects.…”

Bisphosphonate-related osteonecrosis of the jaws: Report of two cases with breast cancer, a dental concern and review of the literature

“…In our first case, the patient was in stage 2 and this treatment plan (local debridement, sequestrectomy, use of antibiotics, daily chlorhexidine mouth rinsing) was performed successfully. Several different adjunctive treatments (ie, hyperbaric oxygen [47,48], parathyroid hormone [49], platelet-rich plasma [50], laser [51,52], ozone therapy [53]) have been advocated to improve healing in BRONJ, but their benefits remain to be clarified.…”

Intérêt de l’oxygénothérapie hyperbare dans la prévention et le traitement des ostéonécroses des maxillaires dues aux bisphosphonates

“…L'application d'ozone sur l'os nécrosé ou sur les sites d'extraction pendant ou après la réalisation du geste chirurgical invasif permettrait de stimuler la prolifération cellulaire et la cicatrisation tissulaire [9]. Le protocole comporte une antibiothérapie de 15 jours (amoxicilline 2 g par jour + acide clavulanique, et métronidazole 1 g par jour) et des séances quotidiennes d'ozonothérapie 7 jours avant et après l'intervention chirurgicale [35].…”