Abstract
Aims: Many papers postulate treatments for established bisphosphonate
related osteonecrosis of the jaws (BRONJ) or advise on ideal long-term
strategies to avoid BRONJ. This article demonstrates prophylactic regimes
and compares their outcomes when patients’ acute symptoms demand
active treatments involving bone. It assesses the efficacy of the protocols
developed at Dundee Dental Hospital for prophylaxis of BRONJ in the
management of patients undergoing oral surgery.
Materials and methods: This prospective study tracked the progress of
patients who were treated in the exodontia clinics and had taken, or were
taking bisphosphonates. Their consequent recovery was documented over
1, 4, 12 and 24 weeks. The prophylactic protocol followed was recorded.
These data were then reviewed for healing, operator, jaw predilection and
co-morbidity influences.
Results: In total, 25 patients were treated over the 1 year period of the study
2008–09. This amounted to 33 oral surgery treatments involving 64
extractions. Several protocols had been followed however these were
grouped into: antimicrobial or chlorhexidine based protocols. In all cases,
complete healing was achieved. Concomitant steroid use and increasing age
were the only associated co-morbidities that increased the length of healing
time. There were no direct associations of any of the other variables with
healing. No prophylactic protocol was superior to another with chlorhexidine
rinses proving as efficacious as any of the antibiotic regimes.
Conclusion: For patients taking oral bisphosphonates, simple extractions
carried out with minimal trauma by graduate and supervised undergraduate
operators with prophylactic chlorhexidine rinses, heal as satisfactorily as
those with antibiotic based protocols for prophylaxis.
related osteonecrosis of the jaws (BRONJ) or advise on ideal long-term
strategies to avoid BRONJ. This article demonstrates prophylactic regimes
and compares their outcomes when patients’ acute symptoms demand
active treatments involving bone. It assesses the efficacy of the protocols
developed at Dundee Dental Hospital for prophylaxis of BRONJ in the
management of patients undergoing oral surgery.
Materials and methods: This prospective study tracked the progress of
patients who were treated in the exodontia clinics and had taken, or were
taking bisphosphonates. Their consequent recovery was documented over
1, 4, 12 and 24 weeks. The prophylactic protocol followed was recorded.
These data were then reviewed for healing, operator, jaw predilection and
co-morbidity influences.
Results: In total, 25 patients were treated over the 1 year period of the study
2008–09. This amounted to 33 oral surgery treatments involving 64
extractions. Several protocols had been followed however these were
grouped into: antimicrobial or chlorhexidine based protocols. In all cases,
complete healing was achieved. Concomitant steroid use and increasing age
were the only associated co-morbidities that increased the length of healing
time. There were no direct associations of any of the other variables with
healing. No prophylactic protocol was superior to another with chlorhexidine
rinses proving as efficacious as any of the antibiotic regimes.
Conclusion: For patients taking oral bisphosphonates, simple extractions
carried out with minimal trauma by graduate and supervised undergraduate
operators with prophylactic chlorhexidine rinses, heal as satisfactorily as
those with antibiotic based protocols for prophylaxis.
| Original language | English |
|---|---|
| Pages (from-to) | 65-71 |
| Number of pages | 7 |
| Journal | Oral Surgery |
| Volume | 3 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - 2010 |
Keywords
- Bisphosphonates
- BRONJ
- Management
- Oral