Pedicled Buccal Fat Pad Flap as a Reliable Surgical Strategy for the Treatment of Medication-Related Osteonecrosis of the Jaw

Rotaru, Horaţiu; Kim, Min-Keun; Kim, Seong‐Gon; Park, Young-Wook

doi:10.1016/j.joms.2014.09.023

Cited by 46 publications

(48 citation statements)

References 31 publications

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“…That is in line with other authors who found a success rate of over 80% after surgery (Carlson & Basile, ; Pautke, Bauer, et al, ; Stanton & Balasanian, ; Voss et al, ). Nevertheless, few similar studies specific to maxillary MRONJ with a limited number of patients have been reported so far (Berrone, Florindi, Carbone, Aldiano, & Pentenero, ; Gallego et al, ; Melville et al, ; Procacci et al, ; Rotaru et al, ; Voss et al, ). Most of these studies included stage 3 lesions and analyzed a single surgical technique.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, fat grafts contain stem cells which can differentiate into different cell types and therefore can promote tissue healing, including bone tissue healing (Burian et al, ; Farre‐Guasch, Marti‐Page, Hernadez‐Alfaro, Klein‐Nulend, & Casals, ). Melville et al () and Rotaru et al () reported 23 and 10 cases of MRONJ effectively treated with BFPF, respectively. Berrone et al () reported a healing rate of 100% after this procedure in five stage 3 MRONJ lesions.…”

Section: Discussionmentioning

confidence: 99%

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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: 99%

Section: Discussionmentioning

confidence: 99%

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

et al. 2018

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“…In existing literature, there are not clear guidelines for the treatment of MRONJ when it is associated with an ipsilateral involvement of multiple paranasal sinuses. Several surgical approaches were described focusing on jaws resection and reconstructions mostly by means of local pedicled flaps such as buccal fat pad flap or microsurgical free flaps. However, most of the studies on this topic failed to address a comprehensive treatment of the rhino‐sinus involvement in this pathology and the related complications.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, early detection and a consequent diagnosis must be carried out as soon as possible by dental or maxillofacial specialists. Recently, surgical reconstruction with pedicled buccal fat pad has been proposed. MRONJ is known to affect mainly the lower jaw, but in roughly one‐third of cases it affects the upper jaw.…”

Section: Introductionmentioning

confidence: 99%

Medication‐related osteonecrosis of the posterior maxilla: surgical treatment using a combined transnasal endoscopic and intraoral approach, our experience with seven consecutive patients

Procacci

Aglietta

Trevisiol

et al. 2017

Clinical Otolaryngology

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“…Large mucosal defects that cannot be covered using local mucosal flaps have been reported to be successfully treated with pedicled buccal fat pad flaps (Rotaru, Kim, Kim, & Park, 2015). Large mucosal defects that cannot be covered using local mucosal flaps have been reported to be successfully treated with pedicled buccal fat pad flaps (Rotaru, Kim, Kim, & Park, 2015).…”

Section: Surgical Management Of Onjmentioning

confidence: 99%

Antiresorptive treatment-associated ONJ

Eleutherakis‐Papaiakovou

Bamias

2017

Eur J Cancer Care

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Osteonecrosis of the jaw (ONJ) is a severe complication of therapy with antiresorptive agents (e.g. bisphosphonates and denosumab), which are used to manage bone metastases from cancer, to reduce the incidence of skeletal-related events. Available data indicate that 0-27, 5% of patients exposed to antiresorptive agents may develop ONJ, depending on the number of infusions and the duration of therapy. Besides antiresorptive therapy, a number of risk factors for osteonecrosis have been identified. Oral surgical procedures, tooth extractions and infection to the jawbones are considered the main risk factors for developing ONJ, when receiving antiresorptive therapy. However, a growing number of patients develop ONJ without apparent risk factors, raising concern for other predisposing factors. Jaw bone necrosis may be irreversible, resulting in a chronic disease with negative impact on the quality of patients' lives. The role of risk reduction strategies like meticulous dental screening and optimal oral hygiene is fundamental for preventing development of ONJ. ONJ is usually treated conservatively to relieve the symptoms and manage jaw bone necrosis. In certain cases, surgical intervention is required. Future research should emphasize individual predisposition to ONJ, more effective preventive measures and more efficient therapeutic procedures.

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Pedicled Buccal Fat Pad Flap as a Reliable Surgical Strategy for the Treatment of Medication-Related Osteonecrosis of the Jaw

Cited by 46 publications

References 31 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

Medication‐related osteonecrosis of the posterior maxilla: surgical treatment using a combined transnasal endoscopic and intraoral approach, our experience with seven consecutive patients

Antiresorptive treatment-associated ONJ

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