Relevance of a Prolonged Preoperative Antibiotic Regime in the Treatment of Bisphosphonate-Related Osteonecrosis of the Jaw

This study indicates that surgical treatment in patients with stage I BRONJ and especially in those with stage II BRONJ in combination with a long-term preoperative antibiotic treatment can lead to a complete healing in 70% to 87% of cases in contrast to 35% to 53% with a short-term regime. The higher success rate after prolonged preoperative antibiotic therapy may be linked to an infectious role in BRONJ etiology requiring adequate treatment. Antibiotics may effectively treat neighboring lightly infected bone, whereas surgery removes the irreversibly infected and necrotic bone. To achieve complete healing, an extended surgical procedure in combination with local mouth rinses and prolonged antibiotic therapy can be recommended for treatment of BRONJ.