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KMID : 0362720150530020120
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Journal of the Korean Dental Association
2015 Volume.53 No. 2 p.120 ~ p.131
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The effectiveness of the surgical approach and drug-holiday on the treatment of bisphosphonate related osteonecrosis of the jaw patient
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Lee Seung-Hyun
Park Kun-Hyo
Lee Jae-Yeol
Kim Yong-Deok
Shin Sang-Hun
Jung In-Kyo
Kim Gyoo-Cheon
Kim Uk-Kyu
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Abstract
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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°Ø 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.
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KEYWORD
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Bisphosphonate-related osteonecrosis of the jaw(BRONJ), Drug-holiday, Conservative treatment, Invasive surgery
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