Resective Surgery versus Debridement in Stage 2 Medication-Related Osteonecrosis of the Jaw
The aim of this study is to analyze surgical and functional outcomes in order to verify the applicability of surgical treatment guidelines as foreseen by MASCC/ISOO/ASCO 2019. Patients affected by stage 2 MRONJ refractory to conservative management were grouped if underwent surgical resection (Group...
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MDPI AG
2021-09-01
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| author | Salvatore D’Amato Antonio Troiano Giorgio Lo Giudice Davide De Cicco Mario Rusciano Gianpaolo Tartaro Giuseppe Colella |
| author_facet | Salvatore D’Amato Antonio Troiano Giorgio Lo Giudice Davide De Cicco Mario Rusciano Gianpaolo Tartaro Giuseppe Colella |
| author_sort | Salvatore D’Amato |
| collection | DOAJ |
| description | The aim of this study is to analyze surgical and functional outcomes in order to verify the applicability of surgical treatment guidelines as foreseen by MASCC/ISOO/ASCO 2019. Patients affected by stage 2 MRONJ refractory to conservative management were grouped if underwent surgical resection (Group A) or debridement (Group B). Health-related quality of life was evaluated by using the European Organization for Research and Treatment of Cancer questionnaires, QLQ-C30 and H&N35. Statistical analysis was performed using Wilcoxon/Mann–Whitney test, Kaplan–Meier test, Cox regression model and Cox multivariate regression. Group A showed higher complete healing cases vs. group B. Recurrence rate difference in group A vs. group B was statistically significant. Debridement is an unfavorable prognostic factor when compared to surgical resection (<i>p</i> = 0.0032, HR 4.9). Quality of life mean values showed a marked improvement in Group A and a slight improvement in Group B. Debridement has 4.9 times more risk to develop recurrence when compared to surgical resection. A more satisfactory quality of life was shown in patients subject to resective surgery with an improving trend from baseline. Debridement patients showed more variability of results and an overall negative trend at the end of the 6-month follow-up. |
| first_indexed | 2024-03-10T07:54:48Z |
| format | Article |
| id | doaj.art-09e962de355144ccb816837f1db625aa |
| institution | Directory Open Access Journal |
| issn | 2076-3417 |
| language | English |
| last_indexed | 2024-03-10T07:54:48Z |
| publishDate | 2021-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Applied Sciences |
| spelling | doaj.art-09e962de355144ccb816837f1db625aa2023-11-22T11:54:34ZengMDPI AGApplied Sciences2076-34172021-09-011118855310.3390/app11188553Resective Surgery versus Debridement in Stage 2 Medication-Related Osteonecrosis of the JawSalvatore D’Amato0Antonio Troiano1Giorgio Lo Giudice2Davide De Cicco3Mario Rusciano4Gianpaolo Tartaro5Giuseppe Colella6Oral and Maxillofacial Surgery Unit, Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania “Luigi Vanvitelli”, Via Luigi De Crecchio, 6, 80138 Naples, ItalyMaxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples “Federico II”, Via Pansini, 5, 80131 Naples, ItalyMaxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples “Federico II”, Via Pansini, 5, 80131 Naples, ItalyMaxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples “Federico II”, Via Pansini, 5, 80131 Naples, ItalyMaxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples “Federico II”, Via Pansini, 5, 80131 Naples, ItalyOral and Maxillofacial Surgery Unit, Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania “Luigi Vanvitelli”, Via Luigi De Crecchio, 6, 80138 Naples, ItalyOral and Maxillofacial Surgery Unit, Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania “Luigi Vanvitelli”, Via Luigi De Crecchio, 6, 80138 Naples, ItalyThe aim of this study is to analyze surgical and functional outcomes in order to verify the applicability of surgical treatment guidelines as foreseen by MASCC/ISOO/ASCO 2019. Patients affected by stage 2 MRONJ refractory to conservative management were grouped if underwent surgical resection (Group A) or debridement (Group B). Health-related quality of life was evaluated by using the European Organization for Research and Treatment of Cancer questionnaires, QLQ-C30 and H&N35. Statistical analysis was performed using Wilcoxon/Mann–Whitney test, Kaplan–Meier test, Cox regression model and Cox multivariate regression. Group A showed higher complete healing cases vs. group B. Recurrence rate difference in group A vs. group B was statistically significant. Debridement is an unfavorable prognostic factor when compared to surgical resection (<i>p</i> = 0.0032, HR 4.9). Quality of life mean values showed a marked improvement in Group A and a slight improvement in Group B. Debridement has 4.9 times more risk to develop recurrence when compared to surgical resection. A more satisfactory quality of life was shown in patients subject to resective surgery with an improving trend from baseline. Debridement patients showed more variability of results and an overall negative trend at the end of the 6-month follow-up.https://www.mdpi.com/2076-3417/11/18/8553MRONJmedication-related osteonecrosis of the jawBRONJdebridementresective surgery |
| spellingShingle | Salvatore D’Amato Antonio Troiano Giorgio Lo Giudice Davide De Cicco Mario Rusciano Gianpaolo Tartaro Giuseppe Colella Resective Surgery versus Debridement in Stage 2 Medication-Related Osteonecrosis of the Jaw Applied Sciences MRONJ medication-related osteonecrosis of the jaw BRONJ debridement resective surgery |
| title | Resective Surgery versus Debridement in Stage 2 Medication-Related Osteonecrosis of the Jaw |
| title_full | Resective Surgery versus Debridement in Stage 2 Medication-Related Osteonecrosis of the Jaw |
| title_fullStr | Resective Surgery versus Debridement in Stage 2 Medication-Related Osteonecrosis of the Jaw |
| title_full_unstemmed | Resective Surgery versus Debridement in Stage 2 Medication-Related Osteonecrosis of the Jaw |
| title_short | Resective Surgery versus Debridement in Stage 2 Medication-Related Osteonecrosis of the Jaw |
| title_sort | resective surgery versus debridement in stage 2 medication related osteonecrosis of the jaw |
| topic | MRONJ medication-related osteonecrosis of the jaw BRONJ debridement resective surgery |
| url | https://www.mdpi.com/2076-3417/11/18/8553 |
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