Bisphosphonate-Related Osteonecrosis of the Jaw Around Dental Implants

Effects of Peri-Implant Plastic Surgery and Hyperbaric Oxygen Therapy on Mandibular Avascular Necrosis After Implant Surgery

“…In some cases, necrotic bone resection may be required, with the margins providing some residual marrow, bleeding points, and bone in normal color, because smaller margins might result in the continuation or extension of the exposed bone. 9,11 Moreover, an FGG was applied to the region so as to avoid additional AVN complications. The FGG was placed into the region to maintain necrotic bone coverage and to eliminate mucogingival stress.…”

“…6 Since 2003, bisphosphonates (BPs) have been commonly accepted as the biggest risk factor of ONJ. [7][8][9] Bisphosphonates reduce the rate of bone remodeling, which may decrease the removal of micro-damaged regions of bone. 6 Furthermore, even in patients who do not take BPs, AVN of the jaws can occur in bony areas that were exposed after invasive dental procedures, such as tooth extraction and implant surgery.…”

“…10 Unfortunately, an efficient treatment protocol has not been determined for AVN of the jaw. 6,9 Currently, surgical debridement, coverage of exposed bone with mucosal flaps, and antimicrobial applications are among the possible treatment options. 9,11 In addition, various studies have reported that hyperbaric oxygen treatment (HBOT), either applied alone or with surgical techniques, is also successful in early-stage AVN.…”

“…6,9 Currently, surgical debridement, coverage of exposed bone with mucosal flaps, and antimicrobial applications are among the possible treatment options. 9,11 In addition, various studies have reported that hyperbaric oxygen treatment (HBOT), either applied alone or with surgical techniques, is also successful in early-stage AVN. 12 Hyperbaric oxygen treatment involves the intermittent inhalation of 100% oxygen at a pressure less than 1.5 atmosphere absolute.…”