Oral and Dental Considerations in Pediatric Leukemic Patient

Table 5

Staging classification and treatment of osteonecrosis of the jaws [14].

Staging classification	Clinical manifestations	Treatment
Stage 1	Exposed bone necrosis or small oral ulceration without exposed bone necrosis, but without symptoms.	Rinses with 0.12% chlorhexidine and checkup.
Stage 2 A	Exposed bone necrosis or a small oral fistula without exposed bone necrosis, but with symptoms controlled with medical treatment.	Rinses with 0.12% chlorhexidine, antibiotic, analgesics, and checkup.
Stage 2 B	Exposed bone necrosis or a small oral fistula without exposed bone necrosis, but with symptoms not controlled with medical treatment.	Rinses with 0.12% chlorhexidine, antibiotic, analgesics, and surgery with removal of the zone of bone necrosis.
Stage 3	Jaw fractures, skin fistula, and osteolysis extending to the inferior border.	Rinses with 0.12% chlorhexidine, antibiotic, analgesics, and extensive surgery with resection of bone.