The Journal of the Korean dental association (대한치과의사협회지)

The Korean Dental Association (대한치과의사협회)
권호 표지

The effectiveness of the surgical approach and drug-holiday on the treatment of bisphosphonate related osteonecrosis of the jaw patient

비스포스포네이트 연관 악골괴사의 치료 방식과 투약 휴지기가 치료 예후에 미치는 영향

  • Rhee, Seung-Hyun (Department of oral and maxillofacial surgery, School of dentistry, Pusan National University) ;
  • Park, Kun-Hyo (Department of oral and maxillofacial surgery, School of dentistry, Pusan National University) ;
  • Lee, Jae-Yeol (Department of oral and maxillofacial surgery, School of dentistry, Pusan National University) ;
  • Kim, Yong-Deok (Department of oral and maxillofacial surgery, School of dentistry, Pusan National University) ;
  • Shin, Sang-Hun (Department of oral and maxillofacial surgery, School of dentistry, Pusan National University) ;
  • Chung, In-Kyo (Department of oral and maxillofacial surgery, School of dentistry, Pusan National University) ;
  • Kim, Gyoo-Cheon (Department of Oral Anatomy, School of dentistry, Pusan National University) ;
  • Kim, Uk-Kyu (Department of oral and maxillofacial surgery, School of dentistry, Pusan National University)
  • 이승현 (부산대학교 치의학전문대학원 구강악안면외과학교실) ;
  • 박군효 (부산대학교 치의학전문대학원 구강악안면외과학교실) ;
  • 이재열 (부산대학교 치의학전문대학원 구강악안면외과학교실) ;
  • 김용덕 (부산대학교 치의학전문대학원 구강악안면외과학교실) ;
  • 신상훈 (부산대학교 치의학전문대학원 구강악안면외과학교실) ;
  • 정인교 (부산대학교 치의학전문대학원 구강악안면외과학교실) ;
  • 김규천 (부산대학교 치의학전문대학원 구강조직학교실) ;
  • 김욱규 (부산대학교 치의학전문대학원 구강악안면외과학교실)
  • Received : 2014.12.08
  • Accepted : 2015.01.27
  • Published : 2015.02.01
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Abstract

Objective: The purpose of this study is to compare the surgical treatment with conservative treatment and to evaluate the effectiveness of drug-holiday in bisphosphonate related osteonecrosis of the jaw (BRONJ) patients who were diagnosed as stage 2. Patients and Method: From January 2012 to October 2014, seventy-two patients who visit to Pusan National University of Dental Hospital were diagnosed as stage 2 of BRONJ. All the patients had taken computed tomography(CT) and panoramic radiography. The surgical treatment including sequestrectomy of necrotic bone and curettage of soft tissue around the sequestrum were performed to fifty patients. Twenty-two patients underwent conservative treatment such as antibiotics medications, mouth rinsing and follow up checking for every two weeks. Prognosis of treatment was classified into 3 groups - response, unresponse, and worsens - according to clinical, radiographic symptoms. P-value less than 0.05 were regarded as significant. Results: In surgery group, forty-five patients (90%) were healed without recurrence or any complication and five patients (10%) showed the wound dehiscence or infection. In conservative treatment group, fifteen patients (68.2%) were healed without any complication, four patients (18.2%) did not show improvement and three(4.2%) patients$^{\circ}{\emptyset}$ symptoms increased. P-value among groups was 0.014. Evaluation of preoperative drug-holiday in surgery group did not show the effectiveness(p=0.478). Conclusion: Statistically, the prognosis of patients with stage 2 BRONJ treated with surgery was significantly better than conservative treatment. There was no statistical difference for the preoperative drug-holiday.

Keywords

References

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