## 3 Results  
An analysis of the results obtained from the Numeric Pain Rating Scale demonstrated that the mean pain intensity before treatment was 8.9 points in the control group, and 9.7 in the main group (Figure 4). These values are indicative of \"unbearable pain.\" After treatment (30 days), the pain score in the control group decreased and amounted to 4.1; this is evidence of the persistence of \"moderate pain\" in the patients. In patients who  
Figure 3: (a,b) CT scan before operation (26 April 2018).  
In the patients in the main and control groups, the pain intensity index values before treatment approached similar values. After surgery, the pain intensity index in the main group was close to normal values. In the control group, 30 days after conservative treatment, there was a tendency for the parameter to decrease; however, after six months, it did not reach the \"no pain\" mark (Figures 8 and 9a,b).  
\begin{table}
\begin{tabular}{c c c} \hline \hline
**Group** & **Period** & **Mean Pain Score** \\ \hline \multirow{3}{*}{Control group(\(n=39\))} & Before treatment & 8.9 * \\ \cline{2-3}  & After treatment & 4.1 \\ \cline{2-3}  & After six months & 3.6 \\ \hline \multirow{3}{*}{Main group(\(n=43\))} & Before treatment & 9.7 \\ \cline{2-3}  & After treatment & 0.5 * \\ \cline{2-3}  & After six months & 0.1 * \\ \hline \end{tabular} Note. * the data are statistically significant (\(p<0.05\)).  
\end{table}
Table 3: Mean pain intensity in patients with MRONJ before and after treatment.  
Figure 7: (**a–d**) Results after three years. (**a**)—full face photo of the patient, (**b**)—the postoperative view of the skin, (**c,d**)—complete epithelhelization achieved.  
In the patients in the main group after six months, the pain intensity score was 36 times lower than that of patients in the control group. Clinically, 10 patients in the control group had a relapse of the disease, which indicates the need for surgical intervention.  
There was no relationship between pain and gender, but there was a direct relationship between the intensity of the pain and the stage of the process.  
The SF-36 Quality of Life Questionnaire showed that in the control group who were treated conservatively, bodily pain before therapy had a score of 91.2 (CI = 95%) (Figure 10). After a combination of antibacterial and anti-inflammatory therapy, this score decreased to 34.3. The mental health score of the patients with bisphosphonate osteonecrosis was 34.2 before treatment and 36.3 after treatment. The difference was 2.1 points, which indicates  
Figure 8: CT scan three years after the surgery.  
Figure 9: (a,b) Results after five years.  
the persistence of discomfort. The remaining parameters improved after treatment, but no complete recovery was achieved.  
Before conservative treatment, this group of patients had a reduced quality of life, and after conservative intervention, they achieved a score of 53.2%, which corresponds to a \"moderate\" quality of life (Figure 11). This suggests the existence of a positive trend. In regard to the mental component after conservative treatment, the quality of life increased (69.1).  
Before radical surgery, the main group of patients also had a high level of bodily pain (95.2), but after surgery this decreased to 12.4. The remaining parameters also showed a significant difference before and after radical surgery, indicating a positive trend (Figure 12).  
Figure 11: Comparison of the physical and mental components in the patients in the control group.  
Figure 10: Comparative analysis of the data obtained with the SF-36 Questionnaire for the patients in the control group.  
The physical component scores in the patients of the main group before and after surgical treatment were 22.3% and 69.7%, respectively, indicating an increased quality of life after segmental resection (Figure 13).