Table 2 Staging and treatment strategies for MRONJ
Staging | Clinical symptoms |
|---|---|
Stage 0 | systemic management, including use of pain medications and antibiotics improvement of oral hygiene (rinsing and cleaning of fistulas and periodontal pockets) |
Stage 1 | antibacterial mouth rinse clinical follow-up on a quarterly basis improvement of oral hygiene (rinsing and cleaning of fistulas and periodontal pockets) patient education and review of indications for continued bisphosphonate therapy |
Stage 2 | combination or monotherapy of symptomatic treatment with oral antibiotics and/or oral antibacterial mouth rinse pain control debridement to relieve soft tissue irritation and infection control |
Stage 3 | antibacterial mouth rinse antibiotic therapy and pain control surgical debridement or resection for longer-term palliation of infection and pain extraction of tooth in exposed bone/necrotic bone as source of infection maintenance of nutrition with supplements and infusions |