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978-3-8439-1538-0, Reihe Zahnmedizin
Operative Behandlung der Bisphosphonat-assoziierten Osteonekrose vom 01.01.2004 bis 31.12.2008: Eine retrospektive Analyse
143 Seiten, Dissertation Philipps-Universität Marburg (2014), Softcover, A5
The aim of the study had two basic goals: One to identify an optimal treatment regime, secondly create a risk profile in order to highlight those that could be perceived as endangered patients of developing BRONJ. This was achieved by reviewing data with respect to patients who had been affected and then received surgical treatment for BRONJ in domo. Our database consisted of 53 cases with a mean age of 68.36 years, including 25 male and 28 female patients. Most of the bisphosphonate used was zoledronic acid (n=29). Bisphosphonate was mainly used to treat malignant diseases, e.g. breastcancer, prostate-cancer or plasmocytome. 60.4% of the BRONJ lesions were localised at the mandible and the most common symptoms were pain, redness, wound-healing deficit, swelling, pressure sores, bad taste in mouth, bulged gingiva and purulence.
The main predisposing event for the development of a BRONJ was extraction and osteolysis and persisting alveolar sockets were common radiological findings. We noticed a statistical correlation between the success of surgical intervention and the relative amount of operations in general anaesthesia. The Median number of operations in patients who were treated with Doxycycline® and a black-light-supported surgical intervention was less than that without those measures (two vs. three). The number of operations differed from one to five in patients who were treated additionally with tetracycline and black light. The number of operations in patients who were treated without additional measures ranged from one to eleven surgical interventions. The duration of BRONJ-treatment came to a length of 180 days, not required.
Statistical correlation highlighted the following: Regression analysis showed a connection between the duration of treatment and the stage of the disease at first consultation, respectively to the type of surgical treatment. With the aid of the Fisher’s exact test, we also found a correlation of the advancement of the disease to the type of surgery respectively to the active agent of the applied bisphosphonate.