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25-03-2024 | Osteonecrosis | Research

Ozone infiltration as an adjunctive treatment to piezoelectric surgery in the management of medication-related osteonecrosis of the jaws: case series of 29 patients

Authors: Funda Goker, Girolamo Donati, Francesco Gallo, Antonella Sparaco, Vito Rania, Alberto Busa, Francesco Grecchi, Emma Grecchi, Gianluca Colapinto, Massimo Del Fabbro

Published in: Oral and Maxillofacial Surgery

Abstract

Purpose

Medication-related osteonecrosis of the jaws has been reported to be associated with bisphosphonate and RANKL inhibitor medications. This prospective clinical study aimed to assess the outcomes of pre-operative ozone infiltration therapy in patients with established MRONJ.

Methods

The treatment protocol for ozone applications were designed as 20 applications ozone infiltration therapy followed by surgical interventions of necrotic tissue debridement using piezoelectric surgery instruments. The evaluation of the results based on the clinical and radiologic specifications considering the necrotic lesion reduction and healing. The study included 31 lesions in 29 patients. The mean follow-up was 23.6 months.

Results

25 lesions out of 31 healed totally without any remissions. The outcomes were not affected by any variables such as gender, age, type of pharmacological treatment, lesion location, and MRONJ staging. The statistically significant results were found among the clinical condition of the patients (p = 0.01) and administration route of medications (p = 0.004). Healing was significantly less in patients that received intra-vascular administrations. Clinical conditions of the patients were divided as osteoporosis, oncologic, and arthritis. Significantly better results were obtained in osteoporosis patients. 38% of the population experienced spontaneous sequestration with signs of improvements and the surgical interventions were canceled. According to the results, total healing of MRONJ lesions was seen in 79% patients (81% lesions).

Conclusion

Ozone therapy and debridement with Piezoelectric surgery can be considered as a safe and beneficial adjunctive treatment alternative for osteonecrosis lesions in cases of established MRONJ.

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Title: Ozone infiltration as an adjunctive treatment to piezoelectric surgery in the management of medication-related osteonecrosis of the jaws: case series of 29 patients
Authors: Funda Goker
Girolamo Donati
Francesco Gallo
Antonella Sparaco
Vito Rania
Alberto Busa
Francesco Grecchi
Emma Grecchi
Gianluca Colapinto
Massimo Del Fabbro
Publication date: 25-03-2024
Publisher: Springer Berlin Heidelberg
Keywords: Osteonecrosis
Wound Debridement
Bisphosphonate
Osteoporosis
Osteoporosis
Published in: Oral and Maxillofacial Surgery
Print ISSN: 1865-1550
Electronic ISSN: 1865-1569
DOI: https://doi.org/10.1007/s10006-024-01246-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Ozone infiltration as an adjunctive treatment to piezoelectric surgery in the management of medication-related osteonecrosis of the jaws: case series of 29 patients

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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