Objectives: Osteonecrosis of the jaws (ONJ) is a known side effect of long-term bisphosphonate (BP) treatment. We present the largest case series of ONJ patients from a single medical center.
Methods: The study included 101 ONJ patients. Data on medical comorbidities, steroid and antiangiogenic drugs intake, type and duration of BP use, possible inciting events, therapy protocol and treatment outcome were recorded.
Results: ONJ was associated with intravenous BPs in 85 patients and with oral BPs in 16 patients. It was diagnosed after 27, 48 and 67 months of zoledronate, pamidronate and alendronate use, respectively. No association was demonstrated between ONJ and type II diabetes mellitus, steroid and anti angiogenic treatment, or underlying periodontal disease. The treatment regimen was conservative and consisted superficial sequestrectomy and trimming of exposed bone as well as long-term empiric antibiotic treatment. This treatment protocol resulted in complete or partial healing in 18% and 52% of the patients, respectively; only 30% had no response.
Conclusions: Conservative treatment regimen resulted in a relatively good outcome and low morbidity.