Treatment strategies and outcomes of bisphosphonate-related osteonecrosis of the jaw (BRONJ) with characterization of patients: a systematic review

Fliefel, Riham; Tröltzsch, Matthias; Kühnisch, Jan; Ehrenfeld, Michael; Otto, Sven

doi:10.1016/j.ijom.2015.01.026

Cited by 300 publications

(288 citation statements)

References 224 publications

(283 reference statements)

Supporting

Mentioning

235

Contrasting

Unclassified

Order By: Relevance

“…23 A good result was obtained after the application of ozone combined with surgical treatments and antibiotic therapy. 24 Moreover, research concerning the use of hyperbaric oxygen therapy especially in combination therapy is being carried out, and the results are promising. 25 The procedure (carried out in the above-described way) has very good effects in the case of patients who take BP orally.…”

Section: Discussionmentioning

confidence: 99%

Bone necrosis associated with the use of bisphosphonates: Case report

Jachewicz¹,

Jakiel²

2017

Dent. Med. Probl.

View full text Add to dashboard Cite

The aim of this study was to present the case of a 68-year-old female patient with jaw bone necrosis associated with the use of bisphosphonates. The case was qualified for the second degree of severity (BRONJ). The study demonstrates a multi-month observation of the patient and describes the sequestrectomy procedure performed, which was supplemented by covering the bone tissue with a collagen sponge. The treatment applied was slightly different from the accepted algorithms of proceedings. The difference was connected with the use of a collagen sponge containing gentamicin (used to cover the bone's surface) after the sequestrectomy. The collagen material, in contrast to the exposed dead bone, is a surface which may be susceptible to epithelization. This gives a possibility to the secondary closing of the wound as a result of granulation and epithelization without the bone's re-exposure. Moreover, the study characterizes indications for the use of bisphosphonates, their chemical structure and mechanism of action. It shows the definition of BRONJ (bisphosphonate-related osteonecrosis of the jaw) and risk factors for its occurrence, as well as prevention and treatment methods.

show abstract

Section: Discussionmentioning

confidence: 99%

Bone necrosis associated with the use of bisphosphonates: Case report

Jachewicz¹,

Jakiel²

2017

Dent. Med. Probl.

View full text Add to dashboard Cite

show abstract

“…6,7 Particularly, results obtained with Er:YAG laser-assisted surgical approaches are significantly better than those obtained through traditional surgery. 8,9 It is worthy to mention here that Rupel et al in a systematic review had reported complete healing Diagnostics Inc., Barnaby, Canada) system was used to induce and visualize AF of the mandibular bone.…”

Section: Surgical Techniquementioning

confidence: 97%

An Auto-Fluorescence guided surgical approach performed with Er:YAG laser and Nd:YAG Low Level Laser Therapy for Medication-Related Osteonecrosis of the Jaw

Giovannacci¹,

Meleti²,

Bonanini³

et al. 2015

J Dent Indones

View full text Add to dashboard Cite

Medication-Related Osteonecrosis of the Jaw (MRONJ) therapy remains an unresolved problem. The proposed conservative and surgical treatment regimens are associated to contradictory success rates. Surgical approach with Er:YAG laser is associated to significant better results compared to medical treatment and traditional surgical approaches. Objective: To describe a new surgical approach that couples the advantages of the Er:YAG laser and the usefulness of the AF in highlighting surgical margins. One of the difficulties encountered during surgical removal of a MRONJ is the precise individuation of necrotic bone margins. Case Report: A case of Stage III mandibular osteonecrosis treated with a new surgical approach is presented. The aim is to describe an auto-fluorescence (AF) guided surgical approach performed with Er:YAG laser and Nd:YAG Low Level Laser Therapy (LLLT). After one month of follow-up, the complete mucosal healing was evident and symptoms was unobserved. Such a technique allowed a highly accurate and minimally invasive approach through the selective ablation of the non-/hypofluorescent areas. Conclusion: Taking into account the advantages of laser therapy and the possible effectiveness of the AF in highlighting surgical margins, this approach would probably achieve excellent outcomes.

show abstract

“…BPs-related osteonecrosis of the jaw (BRONJ) has been characterized as a major side effect of BPs therapy. This serious side effect may appear following a triggering event such as tooth extraction (Fliefel et al 2015). The earliest descriptions of BRONJ were published in 2003 (Fliefel et al 2015), including a letter to the editor by Marx (Marx 2003) who identified 36 cases of painful jaw bone exposures that were unresponsive to surgical or medical treatments.…”

Section: Levels Of Evidence From the Clinical Decision Making Perspecmentioning

confidence: 99%

“…Since then, numerous reports on the development of BRONJ in patients treated with BPs have been published (Fliefel et al 2015;Ruggiero et al 2004;Ruggiero et al 2014), and it was realized that the risk for BRONJ after some periodontal procedures may be comparable to the risk associated with tooth extraction (Ruggiero et al 2014). Therefore, in retrospect, the administration of BPs for periodontal purposes while exposing the patients to the risk of BRONJ is unthinkable.…”

Section: Levels Of Evidence From the Clinical Decision Making Perspecmentioning

confidence: 99%

Classifying scientific evidence as the basis for evidence-based decision making: is strength of evidence absolute?

Rosen

Tsesis

2016

Evid.-based endod

View full text Add to dashboard Cite

Treatment strategies and outcomes of bisphosphonate-related osteonecrosis of the jaw (BRONJ) with characterization of patients: a systematic review

Cited by 300 publications

References 224 publications

Bone necrosis associated with the use of bisphosphonates: Case report

Bone necrosis associated with the use of bisphosphonates: Case report

An Auto-Fluorescence guided surgical approach performed with Er:YAG laser and Nd:YAG Low Level Laser Therapy for Medication-Related Osteonecrosis of the Jaw

Classifying scientific evidence as the basis for evidence-based decision making: is strength of evidence absolute?

Contact Info

Product

Resources

About