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Clinical Oral Investigations

, Volume 19, Issue 6, pp 1329–1338 | Cite as

Stage-related treatment concept of medication-related osteonecrosis of the jaw—a case series

  • Petra RuganiEmail author
  • Stephan Acham
  • Barbara Kirnbauer
  • Astrid Truschnegg
  • Barbara Obermayer-Pietsch
  • Norbert Jakse
Original Article

Abstract

Objectives

There is no general consensus for treatment of medication-related osteonecrosis of the jaw (MRONJ). A stage-related approach that primarily aims to minimize morbidity and preserve function was prospectively evaluated.

Patients and methods

Treatment goals are stable mucosal closure and absence of clinical symptoms. Patients were enrolled between March 2010 and October 2011. MRONJ lesions were treated either by conservative means or surgically by debridement or resective surgery.

Results

In total, 38 patients were treated. Six patients were healed by undergoing conservative measures; nine were treated palliatively. Four patients dropped out after surgery in the recall phase. In 17 of 19 patients (89.5 %) surgical treatment was successful. After a 1-year observation period, the success rate was 92 % (23 of 25), including all patients treated as per protocol.

Conclusion

In stage-related treatment, conservative means or surgical debridement can be successful at early stages. Extensive resection is solely indicated in cases of extended necrosis.

Clinical relevance

The number of patients with MRONJ is steadily increasing. Guidelines to deal with this condition are helpful for both clinicians and dental practitioners.

Keywords

Antiresorptive therapy Jaws Medication-related osteonecrosis Treatment concept Surgical therapy 

Notes

Conflict of interest

None

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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Petra Rugani
    • 1
    Email author
  • Stephan Acham
    • 1
  • Barbara Kirnbauer
    • 1
  • Astrid Truschnegg
    • 1
  • Barbara Obermayer-Pietsch
    • 2
  • Norbert Jakse
    • 1
  1. 1.Department of Oral Surgery and RadiologyMedical University of GrazGrazAustria
  2. 2.Division of Endocrinology and Nuclear Medicine, Department of Internal MedicineMedical University GrazGrazAustria

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