Biphosphonate-associated osteonecrosis can be controlled by nonsurgical management

Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007 Oct;104(4):473-7. doi: 10.1016/j.tripleo.2007.01.008. Epub 2007 May 7.

Abstract

Sixteen patients with jaw biphosphonate-osteonecrosis and with exposed bone areas were subdivided into 2 treatment groups. The first group (7 patients) underwent superficial or radical surgical therapy, while the second (9 patients) underwent antibiotic treatment. A slight reduction of the necrotic areas was observed in 5 of 7 patients in the first group, whereas no change was observed in the remaining 2 patients at 22- and 24-month follow-up. A slight reduction of the necrotic areas was observed in 7 of 9 patients in the second group, whereas no change was observed in the remaining 2 patients at 5- and 24-month follow-up. The statistical analysis showed that the treatment regimen did not significantly influence the dimensional change in the exposed bone. The preliminary results seem to suggest that biphosphonate-associated osteonecrosis can be well controlled by a nonsurgical protocol consisting in long-term administration of antibiotics.

Publication types

  • Controlled Clinical Trial

MeSH terms

  • Aged
  • Amoxicillin-Potassium Clavulanate Combination / therapeutic use*
  • Analysis of Variance
  • Anti-Bacterial Agents / therapeutic use*
  • Bone Density Conservation Agents / adverse effects*
  • Diphosphonates / adverse effects*
  • Female
  • Humans
  • Imidazoles / adverse effects
  • Jaw Diseases / chemically induced
  • Jaw Diseases / drug therapy*
  • Jaw Diseases / surgery
  • Linear Models
  • Male
  • Metronidazole / therapeutic use
  • Middle Aged
  • Osteonecrosis / chemically induced
  • Osteonecrosis / drug therapy*
  • Osteonecrosis / surgery
  • Pamidronate
  • Prospective Studies
  • Zoledronic Acid

Substances

  • Anti-Bacterial Agents
  • Bone Density Conservation Agents
  • Diphosphonates
  • Imidazoles
  • Metronidazole
  • Zoledronic Acid
  • Amoxicillin-Potassium Clavulanate Combination
  • Pamidronate