Use of antibiotic beads in the management of bisphosphonate-related osteonecrosis of the jaw

Bisphosphonate Related Osteonecrosis of the Jaw (BRONJ) is a severe complication described as an area of bone in the jaw that has necrosed and been exposed in the mouth for more than eight weeks in a person taking bisphosphonate. Surgical debridement or resection in combination with antibiotic therapy is advised to resolve the acute infection and pain as well as for long-term palliation, particularly for stage 3 cases. The use of antibiotic beads in the management of osteomyelitis, which has similar clinical features with BRONJ, has been described previously. It is hypothesized that the use of antibiotic beads may be beneficial in the management of BRONJ. Two cases diagnosed with stage 3 BRONJ were managed with the use of antibiotic beads. Treatment protocol consists of thorough debridement and curettage to remove infected and necrotic tissue, placement of antibiotic beads, and primary closure of the wound. Removal of the antibiotic beads is then performed after six weeks. Both cases resolved uneventfully. Results suggest that the use of antibiotic beads can be a viable treatment option in the surgical management of stage 3 BRONJ cases. Further clinical and experimental studies are needed to elucidate the exact relationship and mechanisms involved.

Key words antibiotic beads; bisphosphonate; Bronj; osteonecrosis

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Jan 20, 2018 | Posted by in Oral and Maxillofacial Surgery | Comments Off on Use of antibiotic beads in the management of bisphosphonate-related osteonecrosis of the jaw
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