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Refinements in the reconstruction of bisphosphonate-related osteonecrosis of the jaw ?

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Title: Refinements in the reconstruction of bisphosphonate-related osteonecrosis of the jaw ?
Authors: Maeda, Taku Browse this author
Yamamoto, Yuhei Browse this author
Satoh, Akira Browse this author
Hayashi, Toshihiko Browse this author
Keywords: Bisphosphonate-related osteonecrosis of the
Plate fixation
Microsurgical reconstruction
Issue Date: Mar-2023
Publisher: Elsevier
Journal Title: JPRAS Open
Volume: 35
Start Page: 1
End Page: 5
Publisher DOI: 10.1016/j.jpra.2022.11.004
Abstract: The recommended treatment strategy for stage 3 bisphosphonate-related osteonecrosis of the jaw (BRONJ) is currently rigid plate fixation without bone reconstruction. However, a recent systematic review indicated the utility of microsurgical reconstruction after resection of BRONJ. Several types of flaps have been described but their applications are controversial. Here we present a detailed reconstruction plan for obtaining better outcomes in patients with maxillary and mandibular BRONJ. Given that progressive maxillary BRONJ is often invasive to the skin, including the eyelid, leading to functional loss such as leakage of discharge and ectropion, several revision surgeries are needed to increase the volume in the defect after the free flap transfer. For progressive mandibular BRONJ, hemi-mandibulectomy to subtotal mandibulectomy with an adequate margin from the necrotic bone is necessary, followed by a well-designed fibular free flap.
Type: article
Appears in Collections:北海道大学病院 (Hokkaido University Hospital) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

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