Comparison of auto-fluorescence and tetracycline fluorescence for guided bone surgery of medication-related osteonecrosis of the jaw: a randomized controlled feasibility study

Ristow, Oliver; Otto, Sven; Geiss, C. E.; Kehl, Victoria; Berger, Moritz; Troeltzsch, Matthias; Koerdt, Steffen; Hohlweg-Majert, Bettina; Freudlsperger, Christian; Pautke, Christoph

doi:10.1016/j.ijom.2016.10.008

Cited by 54 publications

(56 citation statements)

References 37 publications

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“…In , Pauthke et al proposed fluorescence‐guided MRONJ surgery as a reliable and reproducible technique for identification of necrotic bone. Several studies have evaluated this technique prospectively and reported a high success rate (over 85%) and complete removal of necrotic bone as verified by histological investigations (Otto et al, ; Pautke, Bauer, et al, ; Ristow et al, ). In this series, 93% of the maxillary lesions operated with fluorescence guidance and 79.6% of those operated without presented complete mucosal healing after the first surgical attempt.…”

Section: Discussionmentioning

confidence: 97%

Surgical treatment of medication‐related osteonecrosis of the upper jaw: Case series

et al. 2018

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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).

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Section: Discussionmentioning

confidence: 97%

Surgical treatment of medication‐related osteonecrosis of the upper jaw: Case series

et al. 2018

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“…Although the preoperative imaging methods could be used to locate the affected region, the multifactorial pathogenesis and the non‐specific radiologic characteristics of BRONJ, especially in the earliest stages, may prevent from a successful surgical management (Baba et al, ; Migliorati, Brennan, & Peterson, ). Some researchers used to utilize tetracycline and its derivatives to guide surgical debridement of BRONJ (Ristow et al, ). However, this method only locates the necrotic bone tissues and ignores the inflammatory bone tissues which also need to be removed.…”

Section: Resultsmentioning

confidence: 99%

“…The main treatment of BRONJ is removing the affected bone through surgery. However, it is difficult for clinicians to distinguish the boundaries of affected bones accurately in surgery (Elad et al, ; Ristow et al, ; Wilde et al, ). An appropriate removal of the affected bone remains an unresolved issue for clinicians.…”

Section: Introductionmentioning

confidence: 99%

The feasibility of locating the affected bone of BRONJ with indocyanine green

et al. 2020

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The morbidity of bisphosphonate‐related osteonecrosis of the jaw (BRONJ) is also increasing with the use of bisphosphonates (BPs). Removing affected bone accurately is the most effective treatment. This study aimed to explore the feasibility of Indocyanine green (ICG)‐based Near‐Infrared fluorescence (NIF) imaging to remove BRONJ affected bone. Firstly, the rat model of BRONJ was constructed. And 5 mg/kg ICG were injected via tail vein, after 12 hr, the affected and healthy bone were dissected for ICG‐based NIF imaging and quantification detection of fluorescence intensity. Finally, all the bone samples were sent for further pathological examination. All the affected bone tissues in rat BRONJ model were fluorescence developed with ICG. And the fluorescence developed regions were further confirmed as affected bone tissues with pathological examination. The fluorescence intensity in affected bone tissues, adjacent, and opposite bone tissues was 1.93*107 ± 2.08*106, 1.19*106 ± 2.33*105, and 1.24*106 ± 1.57*105, respectively (p < .05). Conclusions It was feasible that the extent of affected bone in rat model with BRONJ could be estimated intraoperative via ICG‐based NIF imaging. This novel approach would become an auxiliary method in the treatment of patients with BRONJ in the future.

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“…Table 1 shows a summary of the perioperative antibiotic regimes applied in each study. The most common antibiotic was a combination of penicillin-based antibiotics (ampicillin or amoxicillin) and 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 5 β-lactamase inhibitor (sulbactam or clavulanate) that was used in nine out of the17 studies (52.9%) [4][5][6][7][8][9][10][11][12]. The reported doses of ampicillin/sulbactam were 4.5-9 g/day [5,6].…”

Section: Literature Reviewmentioning

confidence: 99%

“…The reported doses of ampicillin/sulbactam were 4.5-9 g/day [5,6]. The durations were 1 day preoperatively and 5-14 days postoperatively [4,6,7,9,10]. The second most common regime was penicillin or amoxicillin with metronidazole [13-15].…”

Section: Literature Reviewmentioning

confidence: 99%

A literature review of perioperative antibiotic administration in surgery for medication-related osteonecrosis of the jaw

Akashi

Kusumoto

Takeda

et al. 2018

Oral Maxillofac Surg

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Comparison of auto-fluorescence and tetracycline fluorescence for guided bone surgery of medication-related osteonecrosis of the jaw: a randomized controlled feasibility study

Cited by 54 publications

References 37 publications

Surgical treatment of medication‐related osteonecrosis of the upper jaw: Case series

Surgical treatment of medication‐related osteonecrosis of the upper jaw: Case series

The feasibility of locating the affected bone of BRONJ with indocyanine green

A literature review of perioperative antibiotic administration in surgery for medication-related osteonecrosis of the jaw

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