Oliver Ristow1, Thomas Rückschloß2, Jens Bodem2, Moritz Berger2, Eva Bodem2, Steffen Kargus2, Michael Engel2, Jürgen Hoffmann2, Christian Freudlsperger2. 1. University of Heidelberg, (Head of Department: Prof. Dr. Dr. J. Hoffmann), Department of Oral and Maxillofacial Surgery, Im Neuenheimer Feld 400, D-69120, Heidelberg, Germany. Electronic address: Oliver.ristow@med.uni-heidelberg.de. 2. University of Heidelberg, (Head of Department: Prof. Dr. Dr. J. Hoffmann), Department of Oral and Maxillofacial Surgery, Im Neuenheimer Feld 400, D-69120, Heidelberg, Germany.
Abstract
INTRODUCTION: Mucosal wound closure plays a key role after surgery of manifested medication-related osteonecrosis of the jaw (MRONJ). Additional soft tissue layers promise better vascularization and mechanical stability. The objectives of this study were to examine success rates of double-layer closure techniques in MRONJ patients, namely the mylohyoideus muscle flap (MMF) for the lower jaw and the pedicled buccal fat flap (BFF) for the upper jaw. MATERIALS AND METHODS: We designed and implemented a restrospective cohort study and enrolled a sample of patients diagnosed with MRONJ that were treated between 2015 and 2017 with either the MMF or the BFF after removal of the necrotic bone areal. Success was assessed as the maintenance of full mucosal coverage without signs of residual infection at (T0) four weeks (T1), four months (T2), and eight months (T3) after operation. The occurrence of side effects was evaluated. RESULTS: A total of 87 (MMF n = 57; BFF n = 30) patients with 104 MRONJ (MMF 68 = ; BFF n = 36) lesions were included. At the time of the last follow-up, 88.0% (44 of 50) of patients in the MMF group and 93.1% (27 of 29) of patients in the BFF group showed mucosal integrity. No serious side effects were reported. Overall treatment of earlier lesions (stage I and II) showed a better outcome than more severe necrosis (stage III). CONCLUSION: Double-layer closure techniques after surgery in MRONJ patients provide a mechanically stable, well-vascularized covering of the bone defect and should be considered as an option in the standard protocol for all degrees of severity of the disease.
INTRODUCTION: Mucosal wound closure plays a key role after surgery of manifested medication-related osteonecrosis of the jaw (MRONJ). Additional soft tissue layers promise better vascularization and mechanical stability. The objectives of this study were to examine success rates of double-layer closure techniques in MRONJ patients, namely the mylohyoideus muscle flap (MMF) for the lower jaw and the pedicled buccal fat flap (BFF) for the upper jaw. MATERIALS AND METHODS: We designed and implemented a restrospective cohort study and enrolled a sample of patients diagnosed with MRONJ that were treated between 2015 and 2017 with either the MMF or the BFF after removal of the necrotic bone areal. Success was assessed as the maintenance of full mucosal coverage without signs of residual infection at (T0) four weeks (T1), four months (T2), and eight months (T3) after operation. The occurrence of side effects was evaluated. RESULTS: A total of 87 (MMF n = 57; BFF n = 30) patients with 104 MRONJ (MMF 68 = ; BFF n = 36) lesions were included. At the time of the last follow-up, 88.0% (44 of 50) of patients in the MMF group and 93.1% (27 of 29) of patients in the BFF group showed mucosal integrity. No serious side effects were reported. Overall treatment of earlier lesions (stage I and II) showed a better outcome than more severe necrosis (stage III). CONCLUSION: Double-layer closure techniques after surgery in MRONJ patients provide a mechanically stable, well-vascularized covering of the bone defect and should be considered as an option in the standard protocol for all degrees of severity of the disease.
Authors: Anton Straub; Andreas Vollmer; Thiên-Trí Lâm; Roman C Brands; Maximilian Stapf; Oliver Scherf-Clavel; Max Bittrich; Andreas Fuchs; Alexander C Kübler; Stefan Hartmann Journal: Clin Oral Investig Date: 2022-08-09 Impact factor: 3.606
Authors: Oliver Ristow; Lena Hürtgen; Julius Moratin; Maximilian Smielowski; Christian Freudlsperger; Michael Engel; Jürgen Hoffmann; Thomas Rückschloß Journal: J Korean Assoc Oral Maxillofac Surg Date: 2021-04-30
Authors: Sebastian Blatt; Maximilian Krüger; Peer W Kämmerer; Daniel G E Thiem; Philipp Matheis; Anne-Katrin Eisenbeiß; Jörg Wiltfang; Bilal Al-Nawas; Hendrik Naujokat Journal: J Clin Med Date: 2022-01-28 Impact factor: 4.241
Authors: Stefan Moll; Steffen Mueller; Johannes K Meier; Torsten E Reichert; Tobias Ettl; Christoph Klingelhöffer Journal: Oral Maxillofac Surg Date: 2020-11-23