Primary surgical therapy for osteonecrosis of the jaw secondary to bisphosphonate therapy

Deepak Kademani, Sreenivas Koka, Martha Q. Lacy, S. Vincent Rajkumar

Research output: Contribution to journalArticlepeer-review

65 Scopus citations

Abstract

Bisphosphonate chemotherapy is commonly used in the treatment of bone diseases such as osteoporosis, Paget disease, and multiple myeloma and to limit bone pain and hypercalcemia associated with malignant metastatic bone lesions. The introduction of bisphosphonate therapy has improved the quality of life in a vast majority of patients, showing clear medical efficacy. However, since 2003 a growing number of reports have described necrotic bone lesions (osteonecrosis of the jaw [ONJ]) affecting maxillofacial bones in patients who have received chemotherapy with intravenous bisphosphonate therapy. Unfortunately, the development of ONJ has been refractory to conventional treatment modalities. Several treatment options have been proposed for ONJ, most of which focus primarily on conservative management with local irrigation and empirical long-term antibiotic therapy. However, results of treatment have been associated with high failure rates, progression of disease, and continued decline in patients' quality of life. We describe 2 patients in whom primary surgical salvage was performed successfully for ONJ. Our experience indicates that with appropriate technique, primary surgical treatment may offer benefit to selected patients with ONJ.

Original languageEnglish (US)
Pages (from-to)1100-1103
Number of pages4
JournalMayo Clinic proceedings
Volume81
Issue number8
DOIs
StatePublished - Aug 2006

ASJC Scopus subject areas

  • Medicine(all)

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