Treatment methods for bisphosphonate-related osteonecrosis of the jaw (BRONJ) have not been established. Conservative therapy, which was recommended in a position paper published in 2010, does not lead to complete healing in some cases. The treatment method and clinical course of 44 patients with BRONJ, who underwent surgery in our hospital, were investigated, and the following results were obtained:
1) Oral BP was administered in 25 patients, while intravenous BP was administered in 19 patients. Most patients were in stage II.
2) Four patients underwent removal of the necrotic bone only, 37 underwent removal of the necrotic bone as well as the surrounding vital bone, and 3 underwent segmental mandibulectomy. The wound was closed in 35 patients, and packed opened in 9.
3) All 25 patients with oral BP achieved complete remission after surgery.
4) Eleven of 19 patients with intravenous BP achieved complete remission after surgery, and 7 achieved partial remission, although surgical procedure was not effective in one patient.
5) In those who did not achieve complete remission, QOL was improved long term.
6) These findings show that it is appropriate to perform surgical procedures in stage II BRONJ patients.