Division of Restorative Dentistry, Faculty of Dentistry, McGill University, Montreal, QC, Canada.
Int J Oral Maxillofac Surg. 2012 Nov;41(11):1404-9. doi: 10.1016/j.ijom.2012.05.012. Epub 2012 Jun 14.
The purpose of the current retrospective chart review is to describe the outcomes of conservative or surgical treatment of stage 2 bisphosphonate-related osteonecrosis of the jaws (BRONJ). 14 charts (mean patient age 69.07 ± 10.37 years) describing 19 BRONJ stage 2 sites were identified. According to the treatment protocol, all patients received conservative treatment. Surgical treatment was delivered only to sites that did not respond to conservative treatment. Conservative treatment alone was delivered to 11 sites in 8 patients (mean postoperative follow-up 17.6 ± 9.4 months). Surgical treatment was delivered to 8 sites in 6 patients (mean postoperative follow-up 10.0 ± 6.1 months). Bisphosphonate exposure ranged from 1 to 8 years. In most cases, tooth extractions and wearing dentures were reported as triggers for BRONJ. At the last follow-up, BRONJ stage 0 was noted in 7 sites that received conservative treatment and 5 sites that received surgical treatment. Within the limitations of the current chart review, the results showed that although conservative treatment for BRONJ stage 2 can provide favourable outcomes, surgical treatment represents a suitable alternative in non-responsive cases.
本回顾性图表研究旨在描述 2 期双膦酸盐相关性颌骨骨坏死（BRONJ）的保守或手术治疗结果。共确定了 14 份图表（平均患者年龄 69.07±10.37 岁），描述了 19 个 BRONJ 2 期部位。根据治疗方案，所有患者均接受保守治疗。仅对保守治疗无效的部位进行手术治疗。8 名患者的 11 个部位仅接受保守治疗（平均术后随访 17.6±9.4 个月）。6 名患者的 8 个部位接受手术治疗（平均术后随访 10.0±6.1 个月）。双膦酸盐暴露时间为 1 至 8 年。在大多数情况下，拔牙和佩戴义齿被报告为 BRONJ 的诱因。在最后一次随访时，接受保守治疗的 7 个部位和接受手术治疗的 5 个部位 BRONJ 分期均为 0 期。在当前图表回顾的限制内，结果表明，尽管 2 期 BRONJ 的保守治疗可以提供良好的结果，但在非应答病例中，手术治疗是一种合适的替代方法。
