Fat Graft in Surgical Treatment of Medication-Related Osteonecrosis of the Jaws (MRONJ)

Abstract

Background: Although the published literature has grown exponentially during the last few decades, managing medication-related osteonecrosis of the jaws (MRONJ) remains challenging. Since the first description of adipose-derived stem cells, cell therapy showed promising perspectives in surgical treatment of MRONJ. In this study, the beneficial effect of fat graft in surgical treatment of stage 2 and 3 MRONJ patients was assessed. Methods: A retrospective analysis of the evolution pattern of the disease was conducted comparing the outcomes of MRONJ patients who underwent sequestrectomy followed by fat graft (n = 9) and those who received sequestrectomy alone (n = 12). Results: Improvement of the disease stage was observed in 77.8% vs. 22.2% cases in group A and B, respectively (p = 0.030); disease stability was documented in 11.1% vs. 25.0% cases in group A and B, respectively (p = 0.603); worsening of MRONJ stage was observed in 11.1% vs. 50.0% cases in group A and B, respectively (p = 0.159). Conclusions: Despite the small sample size, this study suggests that fat graft may represent a promising low-risk and cost-efficient adjunctive therapy in the surgical treatment of MRONJ patients.

Medication-Related Osteonecrosis of the Jaws: A Comparison of SICMF–SIPMO and AAOMS Guidelines

“…In such cases, the quality of mucosal coverage should be carefully evaluated to avoid potential impairment of the healing process. Recent investigations have shed light on patients with MRONJ who underwent surgical resection of the affected bone, followed by adipose tissue graft application to the surgical site [ 34 ]. This procedure aims to harness the beneficial biological effects of adipose-derived stem cells, which play a significant role in modulating the inflammatory response, stimulating the release of various growth factors, and controlling the microenvironment [ 35 ].…”

Safety and Aesthetics of Autologous Dermis-Fat Graft after Parotidectomy: A Multidisciplinary Retrospective Study

“…He transplanted adipose tissue from a patient’s arm to the orbit to cosmetically improve the sequelae associated with osteomyelitis. Since then, fat grafting has become a progressively employed technique for reconstructive surgery in maxillofacial procedures, like, for example, in case of facial contouring, radiation damage, burn injuries, parotidectomies, or the surgical treatment of MRONJ [ 16 , 17 ]. Fat tissue has a very similar texture and consistency to the parotid tissue [ 1 ], representing an ideal substitute in the case of a partial or complete parotidectomy.…”