Evaluation of segmental mandibular resection without microvascular reconstruction in patients affected by medication-related osteonecrosis of the jaw: a systematic review

Sacco, R.; Umar, G.; Guerra, Raphael Capelli; Akintola, Oladapo

doi:10.1016/j.bjoms.2020.12.014

Cited by 9 publications

(13 citation statements)

References 52 publications

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“…In their systematic review, Sacco et al (2021) confirmed that a segmental resection, without microsurgical reconstruction is a viable alternative for surgery, with promising results, a significantly low recurrence rate, fewer postoperative complications and less comorbidity than with microvascular reconstruction. Oteri et al (2018), meanwhile, stated that marginal resection showed successful results with resolution of acute infection and pain and should be indicated for osteoporotic patients with early-stage, symptomatic MRONJ.…”

Section: Discussionmentioning

confidence: 95%

“…Thus, although the MRONJ treatment options are under debate, and some authors still recommend surgical treatment only for the most severe, symptomatic stages of the disease or in case of failure of a conservative therapy (Ruggiero et al, 2022;Sacco et al, 2021), studies have shown that surgery seems to be effective for the treatment of MRONJ at any stage of the disease (Hauer et al, 2020). Palla et al (2021) reported in their study a surgical success rate for stage I MRONJ of 100%, 71.4% in stage 2 and 60.0% in stage 3.…”

Section: Discussionmentioning

confidence: 99%

“…However, a limited number of studies have proposed free flaps for MRONJ lesions, mainly mandibular lesions, with poor vascularization and large soft tissue defects (Jose et al, 2022;Lemound et al, 2018). Furthermore, Sacco et al (2021) stated that free transfer of vascularized bone tissue and/or free osteo-fasciocutaneous flap as treatment for patients in stages 2 and 3 of MRONJ may increase sequelae and complications. These could decrease the quality of life and increase hospital admissions and costs.…”

Section: Discussionmentioning

confidence: 99%

“…The most recent AAOMS position paper, from 2022, states that patients should be considered to have MRONJ if they present all of the following characteristics shown in Table 2 (Favia et al, 2018;Ruggiero et al, 2022;Sacco et al, 2021).…”

Section: Soft Tissue Flapsmentioning

confidence: 99%

“…Antiresorptive and antiangiogenic agents are mainly used in the treatment of malignant diseases as well as bone metastases, but they have also been used in osteoporosis cases, Paget's disease and hypercalcemia (Sacco et al, 2021). Thus, they are associated with improved quality of life in patients who use them, but they are also related to a higher probability of occurrence of MRONJ cases.…”

Section: )mentioning

confidence: 99%

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Surgical treatments for medication-related osteonecrosis of the jaws: advantages and limitations

Silva

Santiago

Campos

et al. 2023

RSD

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Objective: The purpose of this paper is to discuss the surgical methods available for the treatment of MRONJ, pointing out their advantages and limitations. Methodology: An integrative review of the literature was performed by searching the PubMed virtual database using the MeSH term "bisphosphonate associated osteonecrosis of the jaw/surgery" and including 26 publications. Results: Surgical intervention is presented as a treatment option in an attempt to reduce disease progression with the recognition that this early intervention may predict beneficial outcomes for the patient. Surgical approaches confer superior treatment outcomes over conservative treatments, with success rates of 80-90% and 10-62%, respectively. To establish treatment, consideration should be given to therapy for removing nonhealing exposed bone, which can be accomplished through curettage, sequestrectomy, and surgical resection. When approaching soft tissue, different flaps can be performed, according to their indications. Conclusion: Surgical treatment has shown maintenance of mucosal coverage, improved quality of life, and quick resumption of antiresorptive therapy for all stages of the disease, with high rates of therapeutic success. However, continued efforts should be encouraged to investigate the best treatment for this pathology.

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Section: Discussionmentioning

confidence: 95%