الفهرس 
ContentsOnly 14 pages are availabe for public view
 |  | from | 32 |  |  |
| | | from | 32 | | |
Abstract
Purpose: to evaluate prospectively outcomes of dentoalveolar surgery and its impact on developing BRONJ in bisphosphonates treated cancer patients. Patients and methods: This study was conducted in Mansoura University over a period of 4 years to evaluate outcomes of dentoalveolar surgery in bisphosphonate-treated cancer patients. Fifty six patients were the candidates of this study. They were divided into study group (n= 28) that underwent surgery (teeth extraction), and control group (n= 28) that did not underwent any surgery. Evaluation of healing to detect the occurrence of BRONJ was done. Cases that developed BRONJ were managed according to AAOMS recommendations. Results: from the 28 cases, only 2 cases developed BRONJ (7.14%). They were managed following AAOMS treatment strategies according to their stage of BRONJ. For the 2 cases, cone beam radiological imaging was performed to evaluate the extension of the lesion. One of them considered as stage II BRONJ was managed by debridement and sequestrectomy, histopathological study of necrotic bone was performed. A swap of pus was examined by a culture and sensitivity test. Eight weeks after surgery and providing appropriate antibiotic, normal healing and complete soft tissue coverage was obtained with resolution of BRONJ signs. The other case considered as stage III BRONJ (lesion involving the sinus floor) was managed by debridement and sequestrectomy with histopathological analysis of necrotic bone. The surgical field was covered by PRGF to enhance wound healing. The soft tissue failed to cover the bone with persistence of BRONJ signs. Surgical resection of all infected bone was done. Three months later, resolution of BRONJ signs occurred. Histopathological analysis proved the presence of BRONJ in the bone biopsies obtained from the lesions of both cases. Conclusions: The clinical, radiological and histopathological results of this study indicate that only 7.14% of surgically managed cases developed BRONJ, While 0% of non-surgical cases developed BRONJ. Although there is a difference between the 2 groups, but this difference is statistically not significant suggesting that surgery can be performed for Bps patient if it was necessary. Further prospective studies over a longer period of time with a larger sample size are needed.