Aim: The overall prevention and treatment of Bisphosphonates
related osteonecrosis of the jaws (BRONJ) have been the goals
of our project structured (labelled PROMaB) within the
hospital AOUP “P. Giaccone” (Italy) in order to make better
quality life of patients in therapy with amminobisphosphonates
(NBP).
Material and Methods: Among all procedures, in case of
preprogrammed oral surgical procedure, oral antimicrobial
rinses (i.e. chlorexidine 0,2% mouthwash and 0,5% gel,
three times/day) plus oral systemic antibiotic therapy –e.g.
amoxicilin/clavulanate- have been used to reduce the risk
of BRONJ in secondary prevention (1 day before and 6 days
after). Three hundred and twenty-one patients (206 F and
115 M; range 45-85 yrs; mean age 62,3) under treatment
with NBP (80 ev vs 241 os) have been recruited for dental
examination
Results: 412 dental extractions have been carried out. From
2007 up to date, after application of preventive protocol, only
5 cases of BRONJ (based on clinical and radiological features)
have been observed; the follow up was at least 2 years. Three
patients with BRONJ were treated with zolendronic acid (1
for multiple mieloma, 1 for bone metastasis, 1 for osteoporosis
in off label) and showed some risk factors; one female was
in treatment with pamidronate for osteoporosis, and had
coagulopathy; the last one suffered from osteoporosis treated
with alendronate and clodronate.
Conclusion: In conclusion, despite study limitation, this protocol
could be an easy protocol during dental treatment among NBP
patien