Sven Otto1, Sigurd Hafner, Knut A Grötz. 1. Department of Oral and Maxillofacial Surgery, Ludwig-Maximilians-University, Munich, Germany. Sven.Otto@med.uni-muenchen.de
Abstract
PURPOSE: Hypesthesia or anesthesia of the lower lip (Vincent's symptom) is a common sign in patients with osteomyelitis of the mandible, especially in severe cases. PATIENTS AND METHODS: We observed an involvement of the inferior alveolar nerve in patients with bisphosphonate-related osteonecrosis of the jaw (BRONJ). Surprisingly, we found Vincent's symptom also in patients with limited and early stages of BRONJ. RESULTS: These patients were successfully treated by surgical removal of the necrotic bone combined with preoperative and postoperative administration of antibiotics. We report on the occurrence and management of an involvement of the inferior alveolar nerve in patients with BRONJ and discuss possible causes. CONCLUSION: We conclude that impairment of inferior alveolar nerve function can be an important early symptom or even the presenting symptom of BRONJ that is also easily detectable by bisphosphonate-prescribing physicians. Concerning the management of BRONJ, we conclude that surgical removal of necrotic bone combined with antibiotics is an adequate treatment in patients with osteonecrosis of the jaw.
PURPOSE: Hypesthesia or anesthesia of the lower lip (Vincent's symptom) is a common sign in patients with osteomyelitis of the mandible, especially in severe cases. PATIENTS AND METHODS: We observed an involvement of the inferior alveolar nerve in patients with bisphosphonate-related osteonecrosis of the jaw (BRONJ). Surprisingly, we found Vincent's symptom also in patients with limited and early stages of BRONJ. RESULTS: These patients were successfully treated by surgical removal of the necrotic bone combined with preoperative and postoperative administration of antibiotics. We report on the occurrence and management of an involvement of the inferior alveolar nerve in patients with BRONJ and discuss possible causes. CONCLUSION: We conclude that impairment of inferior alveolar nerve function can be an important early symptom or even the presenting symptom of BRONJ that is also easily detectable by bisphosphonate-prescribing physicians. Concerning the management of BRONJ, we conclude that surgical removal of necrotic bone combined with antibiotics is an adequate treatment in patients with osteonecrosis of the jaw.
Authors: Oliver Ristow; Carlos Gerngroß; Markus Schwaiger; Bettina Hohlweg-Majert; Melanie Ristow; Steffen Koerdt; Roswitha Schuster; Sven Otto; Christoph Pautke Journal: J Cancer Res Clin Oncol Date: 2014-01-28 Impact factor: 4.553
Authors: Sven Otto; Suad Aljohani; Riham Fliefel; Sara Ecke; Oliver Ristow; Egon Burian; Matthias Troeltzsch; Christoph Pautke; Michael Ehrenfeld Journal: Medicina (Kaunas) Date: 2021-05-09 Impact factor: 2.430