Surgical treatment of bisphosphonate-associated osteonecrosis of the mandible: Report of two cases

摘要

Bisphosphonates are used to reduce skeletal-related events in patients with bone-consuming diseases, such as osteoporosis and bone metastases. Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is becoming increasingly common with increasing use of bisphosphonates. We present two cases of BRONJ in a 64-year-old female and a 56-year-old female who were admitted to our department with complaints of purulent discharge and pain of the lower jaw. Both patients had been taking bisphosphonate and were diagnosed with jaw osteonecrosis, which can occur due to long-term use of bisphosphonate. The patients underwent medical treatment, including chlorhexidine rinses and antibiotics. Bone debridement was then performed under local anaesthesia. Both patients recovered well. There are many protocols, guidelines and suggestions on the management of BRONJ. For most patients, a conservative approach with minimal local intervention, if necessary, is appropriate, with extensive debridement of necrotic bone when this fails. In a small number of cases, radical resection of bone and reconstruction may be required.