Sven Otto1, Eva Maria Schnödt2, Selgai Haidari2, Teresa Franziska Brunner2, Suad Aljohani3, Mohamed Mosleh4, Oliver Ristow5, Matthias Troeltzsch2, Christoph Pautke2, Michael Ehrenfeld2, Riham Fliefel6. 1. Head of Department of Oral and Maxillofacial Surgery, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany; Department of Oral and Maxillofacial Surgery and Facial Plastic Surgery, Ludwig-Maximilians-University, Munich, Germany; Experimental Surgery and Regenerative Medicine (ExperiMed), Department of Surgery, Ludwig-Maximilians-University, Munich, Germany. 2. Department of Oral and Maxillofacial Surgery and Facial Plastic Surgery, Ludwig-Maximilians-University, Munich, Germany. 3. Division of Oral Medicine, Department of Oral Diagnostic Sciences, King Abdulaziz University, Jeddah, Saudi Arabia. 4. Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Beni-Suef University, Beni-Suef, Egypt. 5. Department of Oral and Maxillofacial Surgery, Ruprecht-Karls-University, Heidelberg, Germany. 6. Department of Oral and Maxillofacial Surgery and Facial Plastic Surgery, Ludwig-Maximilians-University, Munich, Germany; Experimental Surgery and Regenerative Medicine (ExperiMed), Department of Surgery, Ludwig-Maximilians-University, Munich, Germany; Department of Oral and Maxillofacial Surgery, Alexandria University, Alexandria, Egypt. Electronic address: riham.fliefel@med.uni-muenchen.de.
Abstract
OBJECTIVE: Medication-related osteonecrosis of the jaw (MRONJ) has become a serious concern for patients under antiresorptive treatment, especially in the oncological setting. Different approaches have been described in the management of MRONJ, including innovative autofluorescence-guided surgery. However, until now, there has been a lack of data regarding the outcome. In this study, we evaluated the efficacy of minimally invasive autofluorescence-guided resection in MRONJ. STUDY DESIGN: Seventy-five patients with 82 lesions were included in this retrospective, single-center study. All included patients were diagnosed with MRONJ according to the American Association of Oral and Maxillofacial Surgeons guidelines and underwent autofluorescence-guided surgery with a minimum follow-up of 3 months. The primary outcome was complete integrity of the mucosa and absence of bone exposure. RESULTS: The MRONJ stages were stage 0 (3.7%), stage 1 (3.7%), stage 2 (75.6%), and stage 3 (17%). Overall, complete mucosal healing of all lesions after the first surgery was 81.7% (67 of 82), whereas it was 90.2% (74 of 82) after revision surgery. CONCLUSIONS: The study showed that autofluorescence-guided surgery is a safe and successful treatment option that can be considered for all stages of MRONJ.
OBJECTIVE: Medication-related osteonecrosis of the jaw (MRONJ) has become a serious concern for patients under antiresorptive treatment, especially in the oncological setting. Different approaches have been described in the management of MRONJ, including innovative autofluorescence-guided surgery. However, until now, there has been a lack of data regarding the outcome. In this study, we evaluated the efficacy of minimally invasive autofluorescence-guided resection in MRONJ. STUDY DESIGN: Seventy-five patients with 82 lesions were included in this retrospective, single-center study. All included patients were diagnosed with MRONJ according to the American Association of Oral and Maxillofacial Surgeons guidelines and underwent autofluorescence-guided surgery with a minimum follow-up of 3 months. The primary outcome was complete integrity of the mucosa and absence of bone exposure. RESULTS: The MRONJ stages were stage 0 (3.7%), stage 1 (3.7%), stage 2 (75.6%), and stage 3 (17%). Overall, complete mucosal healing of all lesions after the first surgery was 81.7% (67 of 82), whereas it was 90.2% (74 of 82) after revision surgery. CONCLUSIONS: The study showed that autofluorescence-guided surgery is a safe and successful treatment option that can be considered for all stages of MRONJ.
Authors: Suad Aljohani; Riham Fliefel; Teresa Franziska Brunner; Aristeidis Chronopoulos; Nada Binmadi; Sven Otto Journal: J Int Med Res Date: 2022-06 Impact factor: 1.573