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Journal of Osteoporosis
Volume 2012, Article ID 585434, 8 pages
Clinical Study

Surgical Approach and Laser Applications in BRONJ Osteoporotic and Cancer Patients

1Oral Medicine, Pathology and Laser-Assisted Surgery Unit and Section of Dentistry, Department of ENT/Dental/Ophthalmological and Cervico-Facial Sciences, University of Parma, Via Gramsci, 14-43100 Parma, Italy
2European Master Degree in Oral Laser Applications (EMDOLA), University of Liège, Boulevard de la Constitution, 78-4020 Liège, Belgium

Received 21 November 2011; Revised 28 January 2012; Accepted 20 February 2012

Academic Editor: Matthew R. Allen

Copyright © 2012 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.


Bisphosphonates-related Osteonecrosis of the Jaw (BRONJ) has been reported with increasing frequency in literature over last years, but its therapy is still a dilemma. One hundred ninety patients affected by BRONJ were observed between January 2004 and November 2011 and 166 treated sites were subdivided in five groups on the basis of the therapeutical approach (medical or surgical, traditional or laser-assisted approach, with or without Low Level Laser Therapy (LLLT)). Clinical success has been defined for each treatment performed as clinical improvement or complete mucosal healing. Combination of antibiotic therapy, conservative surgery performed with Er:YAG laser and LLLT applications showed best results for cancer and noncancer patients. Nonsurgical approach performed on 69 sites induced an improvement in 35 sites (50.7%) and the complete healing in 19 sites (27.5%), while surgical approach on 97 sites induced an improvement in 84 sites (86.6%) and the complete healing in 78 sites (80.41%). Improvement and healing were recorded in 31 (81.5%) and 27 (71.5%) out of the 38 BRONJ sites treated in noncancer patients and in 88 (68.75%) and in 69 (53.9%) out of the 128 in cancer patients.