Outcome of Surgical Management of Bisphosphonate-Related Osteonecrosis of the Jaws: Review of 33 Surgical Cases

Purpose: We describe our experience with Surgical management of bisphosphonate-related osteonecrosis of the jaws (BRONJ). Materials and Methods: The data included 33 BRONJ cases treated surgically by a single surgeon at the Hospital of the University of Pennsylvania. Results: Of the 30 debridement patients, 25 (including I sequestrectomy patient who required formal debridement) healed completely. Of the 30 patients who underwent surgical debridement, 18 healed following this initial treatment and remained healed. Of the 4 patients requiring sequestrectomy, 3 healed after the initial treatment. Thus, 28 of 33 patients healed completely with complete mucosal coverage and elimination of pain. Four patients developed occurrence of BRONJ at a separate site. All 4 patients were treated with our Surgery protocol and remain healed. Thus, 32 of 37 BRONJ occurrences have healed with our surgical debridement protocol or sequestrectomy. The follow-up range was 1 to 40 months (average 10.7). Conclusions: The results of our case series have shown that surgical debridement can be successful in treating BRONJ. (C) 2009 American Association of Oral and Maxillofacial Surgeons J Oral Maxillofac Surg 67:943-950, 2009