Suad Aljohani1,2, Matthias Troeltzsch1, Sigurd Hafner1, Gabriele Kaeppler3, Gerson Mast1, Sven Otto1. 1. Department of Oral- and Maxillofacial Surgery, Ludwig-Maximilians-University, Munich, Germany. 2. Department of Oral Basic & Clinical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia. 3. Department of Oral and Maxillofacial Radiology, Clinic for Oral and Craniomaxillofacial Surgery, Ludwig-Maximilians-University, Munich, Germany.
Abstract
PURPOSE: The management of maxillary medication-related osteonecrosis of the jaw (MRONJ) is challenging. Therefore, identifying the proper treatment is important. This study aimed to evaluate the surgical treatment of maxillary MRONJ using single-layer closure with mucoperiosteal flap and double-layer closure with buccal fat pad flap (BFPF) and mucoperiosteal flap and to find the outcomes after rehabilitation with obturators. METHODS: A retrospective analysis was conducted and included all surgically treated and followed-up maxillary MRONJ cases in a single center. Demographics and clinical data, stage of MRONJ, surgical treatment, and treatment outcome were collected. RESULTS: Seventy-nine lesions were included. Removal of necrotic bone was followed by coverage with mucoperiosteal flap in 60 lesions and BFPF in 14 lesions. Seven lesions (five primarily and two following unsuccessful treatment with BFPF) underwent necrectomy and were reconstructed with obturators. Complete mucosal healing was achieved in 76.7% of the lesions covered with mucoperiosteal flap. BFPF led to complete mucosal healing in 85.7% of the lesions. No complications were observed in the defects rehabilitated with obturators. CONCLUSION: Removal of necrotic bone followed by closure with mucoperiosteal flap is reliable for MRONJ treatment. BFPF is effective for closure of MRONJ-related oroantral communications (OACs).
PURPOSE: The management of maxillary medication-related osteonecrosis of the jaw (MRONJ) is challenging. Therefore, identifying the proper treatment is important. This study aimed to evaluate the surgical treatment of maxillary MRONJ using single-layer closure with mucoperiosteal flap and double-layer closure with buccal fat pad flap (BFPF) and mucoperiosteal flap and to find the outcomes after rehabilitation with obturators. METHODS: A retrospective analysis was conducted and included all surgically treated and followed-up maxillary MRONJ cases in a single center. Demographics and clinical data, stage of MRONJ, surgical treatment, and treatment outcome were collected. RESULTS: Seventy-nine lesions were included. Removal of necrotic bone was followed by coverage with mucoperiosteal flap in 60 lesions and BFPF in 14 lesions. Seven lesions (five primarily and two following unsuccessful treatment with BFPF) underwent necrectomy and were reconstructed with obturators. Complete mucosal healing was achieved in 76.7% of the lesions covered with mucoperiosteal flap. BFPF led to complete mucosal healing in 85.7% of the lesions. No complications were observed in the defects rehabilitated with obturators. CONCLUSION: Removal of necrotic bone followed by closure with mucoperiosteal flap is reliable for MRONJ treatment. BFPF is effective for closure of MRONJ-related oroantral communications (OACs).
Authors: Olga Di Fede; Federica Canepa; Vera Panzarella; Rodolfo Mauceri; Carmine Del Gaizo; Alberto Bedogni; Vittorio Fusco; Pietro Tozzo; Giuseppe Pizzo; Giuseppina Campisi; Antonio Galvano Journal: Int J Environ Res Public Health Date: 2021-08-10 Impact factor: 3.390
Authors: Oliver Ristow; Dirk Nehrbass; Stephan Zeiter; Daniel Arens; Julius Moratin; Christoph Pautke; Jürgen Hoffmann; Christian Freudlsperger; Sven Otto Journal: Clin Oral Investig Date: 2020-05-22 Impact factor: 3.573
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