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Head Neck ; 30(9): 1224-30, 2008 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-18642292

RESUMO

BACKGROUND: Osteonecrosis of the jaws occurs after the administration of bisphosphonates. An unequivocal treatment strategy is yet to be devised. We assess the treatment of patients with bisphosphonate-related osteonecrosis of the jaws (BRONJ). METHODS: The investigators studied a prospective cohort of 58 patients 6 months after surgical treatment of BRONJ. Outcome variables were the status of the mucosa, the visual analog score of pain, and prosthetic rehabilitation. Preoperative staging results were compared with the postoperative outcome and statistically evaluated. RESULTS: Of 58 patients, 41 surgically treated patients could be followed up after a mean period of 189 (+/-23) days. Twenty-four (58.5%) were free of pain and had an intact mucosa. A statistically significant improvement was registered between preoperative and postoperative staging (p <.01); 11 of 12 patients who had been treated with a flap procedure for soft tissue closure had an intact mucosa. CONCLUSIONS: This is the first prospective study to report the outcome of treatment in a cohort of patients with BRONJ. Minimal resection of necrotic bone and local soft tissue closure might be a feasible treatment strategy in patients with established BRONJ.


Assuntos
Difosfonatos/efeitos adversos , Doenças Maxilomandibulares/induzido quimicamente , Doenças Maxilomandibulares/cirurgia , Osteonecrose/induzido quimicamente , Osteonecrose/cirurgia , Administração Oral , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Difosfonatos/administração & dosagem , Relação Dose-Resposta a Droga , Esquema de Medicação , Feminino , Seguimentos , Humanos , Incidência , Injeções Intravenosas , Doenças Maxilomandibulares/epidemiologia , Doenças Maxilomandibulares/patologia , Masculino , Pessoa de Meia-Idade , Osteonecrose/epidemiologia , Osteonecrose/patologia , Osteoporose/induzido quimicamente , Osteoporose/tratamento farmacológico , Osteoporose/prevenção & controle , Estudos Retrospectivos , Índice de Gravidade de Doença , Distribuição por Sexo
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