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International Journal of Dentistry
Volume 2014, Article ID 107690, 8 pages
Clinical Study

Conservative Surgical Management of Stage I Bisphosphonate-Related Osteonecrosis of the Jaw

1Unit of Oral Pathology and Laser-Assisted Oral Surgery, Department of Biomedical, Biotechnological and Translational Sciences, University of Parma, 43100 Parma, Italy
2Université de Liège, 4000 Liège, Belgium
3University of Valencia, 46010 Valencia, Spain

Received 31 October 2013; Accepted 21 December 2013; Published 6 February 2014

Academic Editor: Toni Zeinoun

Copyright © 2014 Paolo Vescovi et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Purpose. To report the efficacy of conservative surgical treatment for stage I bisphosphonate-related osteonecrosis of the jaw (BRONJ). Materials and Methods. This study reports the clinical outcomes of 63 patients treated for BRONJ stage I (according to Ruggiero's staging system) at the Oral Pathology and Laser-Assisted Surgery Unit of the University of Parma between January 2004 and January 2011. Surgical interventions were performed, under local analgesia, in patients unresponsive for a period of six months to noninvasive treatments such as cycles of local or systemic antibacterial therapy combined or not to low level laser therapy, ozone therapy, or Hyperbaric Oxygen Therapy. All interventions were performed after the consultation of oncologist or physician. Results. In our experience, conservative surgical treatment is associated with the highest number of BRONJ healed sites in stage I disease. Complete healing was observed in 92.6% of sites surgically treated. Conclusions. This study confirms that treatment of patients affected by minimal bone exposition, (stage I of BRONJ), through conservative surgical strategies, possibly with laser, may result in a high control of the disease in the long term.