Factors influencing surgical treatment of bisphosphonate-related osteonecrosis of the jaws.

Background Bisphosphonates are known to be associated with osteonecrosis of the jaw. We assess factors underlying the success of surgical treatment in patients with bisphosphonate-related osteonecrosis of the jaw (BRONJ). Methods. Fifty-eight patients were investigated 6 months after having surgery. Outcome variables included the stage of disease. Factors underlying the success of surgery such as age, sex, dental procedures, underlying disease, and bisphosphonate therapy were subjected to statistical analysis. Results. In all, 41 patients after surgery could be followed up. Twenty-four patients (58.5%) had an intact mucosa after surgical treatment. A statistically significant improvement was registered between preoperative and postoperative staging (p<.01). Routine dental procedures and the underlying illness influenced the outcome of surgery (p<.05). Patients with osteoporosis and multiple myeloma improved to a greater extent by surgery than those with cancer. Discontinuation of bisphosphonates was found to improve the outcome (p<.05). Conclusions. Surgery is more successful in patients with osteoporosis or multiple myeloma than in those with solid tumors. Discontinuation of bisphosphonate therapy favored the surgical outcome. (C) 2011 Wiley Periodicals, Inc. Head Neck 34: 194-200, 2012