Bisphosphonate-related osteonecrosis of the jaws: Cohort study of surgical treatment results in seventy-four stage II/III patients.

INTRODUCTION: Bisphosphonates are used in the treatment of osteoporosis and bone metastases. They inhibit osteoclast function, thereby decreasing bone resorption. A side effect of these drugs is bisphosphonate-related osteonecrosis of the jaw (BRONJ), which can be difficult to treat. The purpose of this study was to evaluate the surgical treatment protocol used in our hospital for BRONJ patients. The patients were retrospectively analyzed and followed-up at the Leiden University Medical Center.

METHODS: All patients who were referred to our hospital with therapy-resistant BRONJ between 2003 and 2014 were seen. At first presentation, the clinical features, medical and dental history, bisphosphonate use, and the use of other medications were recorded. Patients underwent surgical intervention, performed by senior surgeons, following the principles of our previously published protocol.

RESULTS: Seventy-four patients were followed-up for 6-96 months. Curation was successful with this surgical approach in 93.2% of the patients.

DISCUSSION: All the patients were cured with our surgical protocol, for up to 5 years after surgery. We conclude that this treatment protocol has a high success rate in treating all stages of BRONJ.