Abstract：
OBJECTIVE: 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).
CONCLUSIONS: 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.
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).
CONCLUSIONS: 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.
摘要：
目的：据报道，药物相关的颌骨坏死与双膦酸盐和RANKL抑制剂药物有关。这项前瞻性临床研究旨在评估MRONJ患者术前臭氧浸润治疗的结果。
方法：臭氧应用的治疗方案设计为20种应用臭氧浸润治疗，然后使用压电手术器械进行坏死组织清创手术干预。根据考虑坏死病变减少和愈合的临床和放射学规范对结果进行评估。该研究包括29例患者的31个病变。平均随访时间为23.6个月。
结果：31个病灶中有25个完全愈合，无任何缓解。结果不受任何变量的影响，如性别，年龄,类型的药物治疗，病变位置,和MRONJ分期。在患者的临床状况（p=0.01）和药物的给药途径（p=0.004）中发现了统计学上的显着结果。接受血管内给药的患者的愈合明显较少。将患者的临床状况分为骨质疏松症，肿瘤学，和关节炎。在骨质疏松症患者中获得了明显更好的结果。38％的人口经历了自发隔离，并有改善的迹象，手术干预被取消。根据结果,MRONJ病变完全愈合的患者占79%(81%).
结论：在已确定的MRONJ病例中，臭氧治疗和压电手术清创可被认为是骨坏死病变的安全和有益的辅助治疗选择。
方法：臭氧应用的治疗方案设计为20种应用臭氧浸润治疗，然后使用压电手术器械进行坏死组织清创手术干预。根据考虑坏死病变减少和愈合的临床和放射学规范对结果进行评估。该研究包括29例患者的31个病变。平均随访时间为23.6个月。
结果：31个病灶中有25个完全愈合，无任何缓解。结果不受任何变量的影响，如性别，年龄,类型的药物治疗，病变位置,和MRONJ分期。在患者的临床状况（p=0.01）和药物的给药途径（p=0.004）中发现了统计学上的显着结果。接受血管内给药的患者的愈合明显较少。将患者的临床状况分为骨质疏松症，肿瘤学，和关节炎。在骨质疏松症患者中获得了明显更好的结果。38％的人口经历了自发隔离，并有改善的迹象，手术干预被取消。根据结果,MRONJ病变完全愈合的患者占79%(81%).
结论：在已确定的MRONJ病例中，臭氧治疗和压电手术清创可被认为是骨坏死病变的安全和有益的辅助治疗选择。
