In accordance to some contemporary scientific literature the incidence of BRONJ in patients receiving IV BPs i.v. ranges from 0.8% to 16%. Different treatment protocols of BRONJ are described in the world scientific literature.
Aim : To improve the efficiency of BRONJ treatment in cancer patients with a history of intravenous IV bisphosphonate therapy (Zometa, Zoleriks).
Materials and methods : At our Department we have treated 30 patients with BRONJ. Patients had a history of intravenous bisphosphonate therapy due to following malignances: breast cancer (14 patients), prostate cancer (8 patients), multiple myeloma (6 patients), kidney cancer (2 patients). It should be mentioned that all patients had no clinical and radiographic signs of sequestrum presence in the beginning of the treatment. Localization of osteonecrosis: the maxilla in 13 patients, mandible – in 17 patients. In most patients, the development of osteonecrosis was preceded by the removal of one or more teeth, in 2 patients BRONJ occured due to the chronic trauma of dentures. All patients received conservative treatment (weekly antiseptic rinses, antibacterial therapy), 15 patients underwent ozone therapy (10 sessions of 3 min with a 5-weeks break).
Results : In all patients who received ozone therapy, there was a formation of sequestrums that were removed with forceps under local anesthesia. Terms of formation of seizures ranged from 6 to 15 months. A year after sequestrectomy according CT scanes showed signs of osteoregeneration. There were indicated no signs of osteonecrosis after sequestrumectomia (1 year follow-up).
Conclusion : The use of ozone therapy in the treatment of BRONJ is effective in cases when both radiographic or clinical signs of sequestrum presence are absent. No need for soft tissue closure after the sequestrum removal and atraumatic sequestrectomy (no damage to healthy bone tissue) contribute to a significant reduction in the risk of recurrence in the postoperative period.