Bisphosphonate-Related Osteonecrosis of the Jaw: A Retrospective Study on the Role of Dental Prophylaxis

Clinicians use bisphosphonates in neoplastic and metabolic bone diseases. Osteonecrosis is the main complication of the maxillary bones, along with late mucosal healing with necrotic bone exposure, pain, burning sensation, paresthesia, and is commonly associated with osteonecrosis. In the dental unit of our department, we checked 181 patients, and divided them into three groups: patients who had not undergone therapy, patients who were currently undergoing bisphosphonate therapy, and those who had completed bisphosphonate therapy (but who had not been followed-up). For clinical management, patients were treated with a dental prophylaxis protocol or drug therapy, involving topical and/or systemic administration, and then underwent surgical resections when the osteonecrosis did not improve with any treatment. Variability with the percent of complications was statistically significant in the three groups. Despite the limited number of patients in this study, which will require further investigation, our experience demonstrated that preventive strategies in relation to complications are crucial. At this point, a satisfactory treatment for this pathology does not exist.