Effectiveness of Surgical Marginal Resection with Piezoelectric Device on Bisphosphonate-Related Osteonecrosis of the Jaws: A Retrospective Study

Objective: This study aims to investigate the efficacy of marginal resection using a piezoelectric device in patients with Bisphosphonate-Related Osteonecrosis of the Jaw (BRONJ). Methods: A retrospective study was conducted on subjects treated at the Dental Clinic University Hospital of Padua (Italy) from January 2017 to April 2024. Patients diagnosed with BRONJ (stages 1 and 2) who underwent marginal resection of the maxillae using a piezoelectric instrument were included. Exclusion criteria included patients who had received radiotherapy to the head and neck, those with Medication-Related Osteonecrosis of the Jaw (MRONJ), and those with primary tumors of the maxillary bones. Marginal resection was considered an effective treatment when complete epithelialization of the surgical site was achieved, with no signs or symptoms of disease, and the condition remained stable one-year post-operation. Results: 21 patients (17 females and 4 males) were selected. A single resection was performed for each patient, resulting in a total of 21 surgeries: 14 in the mandible and 7 in the maxilla. At one-year post-surgery, 20 patients showed no signs or symptoms of the disease. 1 patient experienced two recurrences, both of which were subsequently treated. Conclusions: The study demonstrates that marginal resection using a piezoelectric device is an effective procedure for the treatment of BRONJ, although it remains a relatively invasive and destructive therapeutic approach.