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Oral Oncol. 2014 Nov;50(11):1049-57. doi: 10.1016/j.oraloncology.2014.08.016. Epub 2014 Sep 17.

A systematic review of therapeutical approaches in bisphosphonates-related osteonecrosis of the jaw (BRONJ).

Oral oncology

Katia Rupel, Giulia Ottaviani, Margherita Gobbo, Luca Contardo, Giancarlo Tirelli, Paolo Vescovi, Roberto Di Lenarda, Matteo Biasotto

Affiliations

  1. Division of Oral Medicine and Pathology, Dental Science Department, University of Trieste, Trieste, Italy.
  2. Department of Otorhinolaryngology, Head and Neck Surgery, University of Trieste, Trieste, Italy.
  3. Unit of Oral Pathology and Laser-Assisted Oral Surgery, Department of Biomedical, Biotechnological and Translational Sciences, University of Parma, Parma, Italy.
  4. Division of Oral Medicine and Pathology, Dental Science Department, University of Trieste, Trieste, Italy. Electronic address: [email protected].

PMID: 25240948 DOI: 10.1016/j.oraloncology.2014.08.016

Abstract

OBJECTIVES: The clinical management of bisphosphonate-related osteonecrosis of the jaw (BRONJ) remains controversial. Since universally accepted guidelines have not been released yet, clinicians usually chose the type of treatment according to position papers based on expert opinion, or on empirical experience. The aim of this systematic review is to identify different therapeutical approaches for BRONJ that have been described in literature and to describe their effectiveness.

MATERIALS AND METHODS: A Medline via Pubmed and Scopus database literature search was conducted and all publications fulfilling the inclusion and exclusion criteria were included in eligibility assessment. The full texts of 146 retrieved articles were then screened and 40 studies were included in the quality assessment process.

RESULTS: After quality assessment, 22 full text articles were selected for the final review. 14 articles out of 22 were screened for stage-related outcomes. The overall outcome results and results for every disease stage were the highest when patients were treated with extensive surgery or extensive laser assisted surgery.

Copyright © 2014 Elsevier Ltd. All rights reserved.

Keywords: Bisphosphonates; Nonsurgical approaches; Osteonecrosis; Surgical approaches; Systematic review; Therapeutical approaches

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