Objective: Purpose of this study is to compare the surgical treatment and conservative treatment and to evaluate the effectiveness of drug holiday in bisphosphonate related osteonecrosis of the jaw(BRONJ) patients who was diagnosed as stage 2.
Patients and Method : From January 2012 to October 2014, Seventy-two patients who came to Pusan National University of Dental Hospital were diagnosed as stage 2 of BRONJ. All the patinets were taken computed tomography(CT) and panoramic radiography. Fifty patients were performed the surgical treatment including sequestrectomy of necrotic bone and curettage of soft tissue around the sequestrum. Twenty-tow patients underwent conservative treatment such as antibiotics medications, mouth rinsing and follow up checking for every two weeks. Each study was analyzed by Statistical Package for Social Sciences(SPSS, version 20.0, USA) software and verifying of significance test between two groups was khai square test and evaluation of drug-holiday was Mann-whiteney test. P-value less than 0.05 were deemed significant.
Results: In surgery group, forty-five patients(90%) was healed with out recurrence or any complications, five patients(10%) showed the wound dehiscence or infection. In conservative treatment group, fifteen patients(68.2%) were healed without complications, four patients(18.2%) did not show improvement and symptoms of three(4.2%) patients were increased. P-value between groups was 0.014. Evaluation of preoperative drug holiday in surgery group did not show the effectiveness.(p=0.478)
Conclusion: The prognosis of patients with stage 2 BRONJ healed by surgery was better than conservative treatment statistically significant. There was no statistical difference for the preoperative drug holiday.