Antiresorptive agent-related osteonecrosis of the jaw (ARONJ) is an adverse event induced by antiresorptive agents (ARAs). The purpose of this study was to evaluate variables, mainly surgery and hyperbaric oxygen (HBO) therapy, associated with treatment outcomes in patients with a diagnosis of ARONJ at a single center. We enrolled consecutive patients who presented to our hospital for the management of stage 2 or 3 ARONJ between January 2003 and December 2019. The relationship between potentially predictive factors and outcome variables was examined using statistical analyses, along with a subgroup analysis based on disease stage. Of 252 patients included in this study, 206 had stage 2 ARONJ and 46 had stage 3 ARONJ. There were 119 patients with osteoporosis and 133 with malignant disease. In total, 139 patients were healed, and the healing rate of patients with stage 3 ARONJ was lower than that of patients with stage 2 ARONJ. With regard to the combination of surgery and HBO therapy, most patients underwent HBO before and after surgery. In the univariable analysis, surgery showed a therapeutic effect in both stage 2 and 3 ARONJ, whereas HBO showed a therapeutic effect in stage 2 ARONJ. In the multivariable analysis for stage 2 ARONJ, extensive surgery showed a stronger association with healing than conservative surgery, whereas ≥46 sessions of HBO therapy was less associated with healing than was non-HBO therapy. Our findings suggest that extensive surgery is highly effective against ARONJ regardless of disease stage if there is a sequestrum separation and systemic tolerance, whereas HBO therapy before and after surgical approach can be effective. Further studies are needed to identify treatment strategies for patients with treatment-refractory ARONJ who may be forced to undergo long-term HBO therapy with the expectation of sequestrum separation.

与抗吸收剂相关的颌骨坏死（ARONJ）是由抗吸收剂（ARAs）引起的不良事件。这项研究的目的是评估单一中心诊断为ARONJ的患者的变量，主要是手术和高压氧（HBO）治疗与治疗结果相关。我们纳入了2003年1月至2019年12月间到我院治疗ARONJ的2或3期的连续患者。使用统计学分析以及基于疾病分期的亚组分析，检查了潜在预测因素与结果变量之间的关系。在这项研究的252名患者中，有206名患有2期ARONJ，46名患有3期ARONJ。骨质疏松症119例，恶性肿瘤133例。总共有139名患者得到了治愈，3期ARONJ患者的治愈率低于2期ARONJ患者。关于手术和HBO疗法的结合，大多数患者在手术前后接受HBO治疗。在单变量分析中，手术在ARONJ的第二阶段和第三阶段均显示出治疗效果，而HBO在ARONJ的第二阶段中显示出治疗效果。在2级ARONJ的多变量分析中，广泛手术显示出与保守治疗相比更强的愈合相关性，而≥46疗程的HBO治疗与非HBO治疗的愈合相关性更低。我们的研究结果表明，如果存在死骨分离和全身耐受性，无论疾病阶段如何，广泛的手术对ARONJ都是高度有效的，而手术前后的HBO治疗可能是有效的。