University Clinic of Craniofacial, Maxillofacial and Oral Surgery, Medical University of Vienna, Austria.
Oral Oncol. 2013 Jan;49(1):66-70. doi: 10.1016/j.oraloncology.2012.07.008. Epub 2012 Aug 11.
Bisphosphonates are associated with osteonecrosis of the jaw. Bisphosphonate-related osteonecrosis of the jaw (BRONJ) may be treated conservatively or by surgery.
108 patients underwent surgery and 88 patients were followed for a mean period of 337 days. Age, gender, dental procedures, underlying disease, and the role of bisphosphonate treatment in the success of surgery were evaluated retrospectively.
Surgical treatment improved the stage distribution from 19% stage I, 56% stage II and 25% stage III to 59% intact mucosa, 19% stage I and 13% stage II and 8% stage III. The improvement in the stage of disease achieved by surgery was statistically significant. Further relevant parameters that favor a positive outcome of surgery were the event triggering the outbreak of BRONJ (p=0.05) and the underlying disease (p=0.05). BRONJ in the maxilla necessitated repeat surgery significantly earlier than did BRONJ in the mandible (p=0.03).
Effective surgery might improve the outcome of BRONJ, although prevention still is the most important aspect of this condition.
双膦酸盐与下颌骨坏死有关。双膦酸盐相关下颌骨坏死（BRONJ）可通过保守或手术治疗。
108 例患者接受了手术，88 例患者平均随访 337 天。回顾性评估了年龄、性别、牙科手术、基础疾病以及双膦酸盐治疗在手术成功中的作用。
手术治疗改善了疾病的分期分布，从 19%的 I 期、56%的 II 期和 25%的 III 期转变为 59%的完整黏膜、19%的 I 期、13%的 II 期和 8%的 III 期。手术对疾病分期的改善具有统计学意义。有利于手术取得积极结果的其他相关参数包括引发 BRONJ 爆发的事件（p=0.05）和基础疾病（p=0.05）。上颌骨的 BRONJ 需要再次手术的时间明显早于下颌骨的 BRONJ（p=0.03）。
有效的手术可能改善 BRONJ 的预后，尽管预防仍然是这种疾病最重要的方面。
