III medication-related osteonecrosis of the jaw

148 sclerosis, presence or absence of subperiosteal bone formation, sequestra, the visibility of the mandibular canal, cortical border were scored. Differences between outcomes of denosumab-related osteonecrosis (DRONJ) of the jaw and BRONJ patients were studied. Findings: In denosumab cases predominantly sclerosis was seen. Bisphosphonates more sclerosis depending on the duration of the use or the potency of the bisphosphonates. Sequestra were rare with denosumab necrosis compared to bisphosphonate necrosis. Subperiosteal bone formation was predominantly seen in patients using bisphosphonates. Prominent lamina dura, the visibility of the mandibular canal and cortical border were seen in both denosumab and bisphosphonates. Conclusions: This study shows a difference in radiological aspects between denosumab and bisphosphonate cases. In denosumab a sclerosis is seen which is visible only in long-term bisphosphonate cases. Sequestra were rare in denosumab. These effects are possibly caused by a difference in the remaining functioning amount of osteoclasts. Further research is mandatory. http://dx.doi.org/10.1016/j.ijom.2017.02.510 Surgical treatment of a cohort of 150 patients with stage II/III medication-related osteonecrosis of the jaw S.E.C. Pichardo ∗ , J.P.R. van Merkesteyn Leiden University Medical Center, The Netherlands Background: A side effect of antiresorptive medication such as bisphosphonates and denosumab is medication-related osteonecrosis of the jaw (MRONJ). This can be difficult to treat. Objectives: The aim of this study was to evaluate the surgical treatment protocol used in our hospital for MRONJ patients. The patients were analysed and followed at the Leiden University Medical Center. Methods: 150 patients who were seen with therapy-resistant MRONJ between 2003 and 2016 were analysed. Clinical features, medical and dental history, antiresorptive use, and the use of other medications were recorded. The thorough surgical intervention was combined with antimicrobial treatment and only performed by senior surgeons, following the principles of our previously reported protocol. Findings: 125 patients were surgically treated and followed for 6–105 months with a mean of 18 months. The surgical approach was successful in 92% of the patients. Conclusion: More than 90% of the patients were cured with our surgical protocol. We conclude that this combined antimicrobial and surgical treatment protocol has a high success rate in all stages of MRONJ. http://dx.doi.org/10.1016/j.ijom.2017.02.511

Study on outcomes of oral squamous cell carcinoma after treatment for two years follow-up at Bangabandhu Sheikh Mujib Medical University M.S. Rahman ∗ , A.F.M.S. Rahman Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh Objective: To evaluate the treatment outcome of oral squamous cell carcinoma patients by routine follow-up visit and by this efficacy of institutional management. Methods: In the study 56 patients, aged 26–75 years treated at BSMMU for squamous cell carcinoma of oral cavity were included. Patients were treated by different modality such as surgery with incomplete/delayed/no radiotherapy (32.14%), surgery with radiotherapy (53.57%), surgery with concomitant radiochemotherapy (10.71%) and neoadjuvant therapy then surgery and adjuvant therapy (3.57%). By routine follow-up, suspected new tumour growth was determined and fine-needle aspiration cytology and histopathology was done. Residual tumour growth, local recurrence, lymph node metastasis and second primary tumour growth were detected and by this overall outcome measured. Results: The majority of patients were female and the male to female ratio was 1:1.4. Tumours of different sites of oral cavity were treated of which stage I, 23.21%; stage II, 62.5%; stage III, 14.21%; and stage IV patients were not included. Overall outcome of treatment was 50.0% for two years follow-up. Residual tumour growth was 9.09%, local recurrence was 36.36%, lymph node metastasis was 2.27% and second primary tumour was 2.27% within two years. Outcome for two years in stage I 100%, in stage II 43.3% and in stage III 28.5%. Statistical analysis with SPSS version 10 showed P value for one-year follow-up. Conclusion: Our results suggest that to evaluate the treatment outcome routine follow-up is necessary. Also efficacy and failure of treatment can be measured. http://dx.doi.org/10.1016/j.ijom.2017.02.512 Bisphosphonate-related osteonecrosis of the jaws: our experience in up to 120 cases C.E.X.S. Ribeiro da Silva ∗ , A.C. Rodriguez, D.M. Costa, M. Martins, V. Oliveira, R. Murad Neto Instituto de Ensino, Pesquisa e Difusão Prevent Senior, Brazil Osteonecrosis of the jaw has been related to the use of bisphosphonates for more than a decade, with numerous attempts of different treatments and even the presentation protocols by surgeons associations. We aim to present a series of clinical cases with various complexities, presenting forms of treatment adopted by our service. We collected clinical data from 120 patients, considering the type of bisphosphonate treatment, time of use, location and extent of osteonecrosis and the treatment performed in our hospital. We have adopted the protocol to perform surgical removal of necrosis, associated with pentoxifylline and tocopherol, and hyperbaric chamber therapy for indicated cases. We resumed the treatment of overall shape necrosis in 90% of cases, and significant improvement of signs and symptoms in 10%. We conclude that the combined use of surgery to other therapies may be indicated