In comparison with techniques described in the literature, the main advantages of the modified Risdon approach are the following: no need for facial vessels identification; direct, fast, and safe approach to mandibular angle and subcondylar region; relatively simple surgical technique and good cosmetic result – due to aesthetically placed incision. This approach could be recommended for subcondylar fracture as a simplified and safe procedure.

This retrospective cohort study aims to describe characteristics of patients with MRONJ, to identify factors associated with MRONJ development, and to examine variables associated with favourable outcome. Totally 32 patients were followed and observed: 21 females and 11 males, in the age range 35-84 in the period from 2009 to 2018. Clinical, radiological examination (Orthopantomograph and CBCT) and biopsy were performed in order to achieve diagnosis. Demographic and clinical variables were taken into consideration: sex, age, primary disease, medication type, mode of delivery, anatomic location, drug treatment duration, timing of tooth extraction, chemotherapy, presence of bone metastasis, aetiology of MRONJ, disease stage, and treatment modality. MRONJ developed under osteoporosis and malignant disease in 11 and 21 patients, respectively. MRONJ development was triggered by tooth extraction or trauma in 30 out of 32 cases, whereas the two patients developed MRONJ spontaneously. Stages I, II, and III were confirmed in 5 (16%), 18 (58%), and 9 (28%) patients, respectively. Mandible was affected in 23 (72%) patients. MRONJ was treated in our department by conservative and surgical modality. In this study we found that 65% of all patients were classified in the cured/improvement group and 35% in the stable/progression group. The female gender, osteoporosis as primary disease, oral regime intake, shorter period on BPs, earlier stage of disease, and specific anatomic localisation (frontal and premolar maxilla) were factors associated with better response to therapy and favourable clinical outcome. Comprehensive treatment protocol and further randomized studies are necessary for further improvements.

Intraosseous focal venous malformation of the mandibular body: cone beam computed tomography planning followed by piezoelectric knife resection and free bone graft reconstructionIntraosealna fokalna venska malformacija tela donje vilice: planiranje piezoelektrične resekcije pomoću kompjuterizovane tomografije konusnim zrakom i rekonstrukcija slobodnim koštanim transplantatom Abstract Introduction. Intraosseous vascular malformation could be life-threatening due to uncontrolled hemorrhage after tooth extraction. According to biological behavior of this lesion, adequate diagnostic and treatment strategies are necessary in order to avoid possible complications. We reported cone beam computed tomography (CBCT) planning of an urgent en bloc resection of an intraosseous venous malformation by piezoelectric knife. Case report. A 55-year-old man was submitted to CBCT planning followed by piezoelectric knife resection of an intraosseous focal venous malformation of the mandibular body. Immediate reconstruction of the defect using iliac bone free graft was performed. The surgical treatment was uneventful and a 2-year follow-up revealed no signs of recurrence.Conclusion. Piezoelectric knife could provide precise, safe and bloodless procedure which is especially important in this pathology. Advantages of this technique are: lower risk of damaging soft tissue structures, precise osteotomy and bloodless surgery. Moreover, using piezosurgery bone knife, blood transfusion and blood transmitted diseases could be avoided. This case highlights the importance of CBCT as planning tool for resection of the mandible, using piezoelectric knife as safe method to achieve bloodless surgery.Nikolić Ž, et al. Vojnosanit Pregl 2017; 74(5): 483-488.

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