Treatment of medication-related osteonecrosis of the jaws (MRONJ) with ultrasonic piezoelectric bone surgery. A case series of 20 treated sites
Treatment of medication-related osteonecrosis of the jaws (MRONJ) with ultrasonic piezoelectric bone surgery. A case series of 20 treated sites
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DOI：
10.1007/s10006-016-0597-7
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发表时间：
2017-03-01
影响因子：
1.8
通讯作者：
Orru, Germano
中科院分区：
文献类型：
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作者：
Blus, Cornelio;Giannelli, Giulio;Orru, Germano
关于如何成功治疗药物相关性颌骨骨坏死（MRONJ）尚未达成共识。我们在此报告压电骨手术结合抗生素治疗MRONJ的应用及其可能的益处。一个连续18例患者的队列接受了MRONJ治疗;他们涉及20个部位，15个在下颌骨，5个在上颌骨。采用功率最大90 W的压电外科器械清除坏死区并进行清创，结合抗生素治疗，所有患者均在1个月内愈合并获得完全的软组织闭合。在目前的随访（10-54个月）中没有观察到症状复发。我们假设所有治疗部位的愈合可能是由于骨消融、生物膜改变和抗生素给药的协同作用。生物膜的改变可能使抗生素更容易接触到相关的细菌。这些令人鼓舞的结果保证了对使用超声手术治疗MRONJ患者的进一步研究，以证实或反驳假设的效果。
There is no consensus on how to successfully treat medication-related osteonecrosis of the jaws (MRONJ). We report here on the application of piezoelectric bone surgery to treat MRONJ in combination with antibiotherapy and on its possible benefit.A cohort of 18 consecutive patients has been treated for MRONJ; they involved 20 sites, 15 in the mandible, and five in the maxilla. Surgical removal of the necrotic areas and debridement was performed with a powerful piezoelectric surgery device (max 90 W) in combination with antibiotherapy.All patients healed and obtained a complete soft tissue closure within 1 month. No recurrence of the symptoms was observed during the present follow-up (10-54 months).We hypothesize that healing of all treated sites might have resulted from the synergic effect of bone ablation, biofilm alteration, and antibiotic administration. Biofilm alteration might have permitted a better access of antibiotics to the involved germs. These encouraging results warrant further studies on the use of ultrasonic surgery to treat MRONJ patients in order to confirm or refute the hypothesized effect.