Management of maxillofacial osteonecrosis

Non-Radiation-Related Osteonecrosis of the Jaws in Dogs: 14 Cases (1996–2014)

“…This case series describes the clinicopathological features and possible inciting factors of non-radiation-related ONJ in dogs, and reports on the surgical treatment and outcome. The clinical manifestations of ONJ observed in the dogs reported here were similar to those described previously in humans and dogs ( 5 – 7 ), and are illustrative of the potential impact on the health status and quality of life of affected individuals. Even though the patient population included was not compared to the overall hospital populations, the prevalence of non-radiation-related ONJ in dogs appeared low: 14 dogs in a period of 18 years were presented to 3 different referral institutions.…”

“…Osteonecrosis of the jaws (ONJ) is a clinical term used in human medicine, and refers to chronically exposed necrotic mandibular or maxillary bone ( 1 – 4 ). A condition that resembles this has been anecdotally reported in dogs ( 5 – 7 ). The definitive diagnosis of ONJ is based on historical, clinical, diagnostic imaging, and histopathological findings ( 3 , 8 ).…”

“…The treatment of severe or advanced ONJ is typically surgical regardless of possible inciting factors, and is often followed by a course of oral antibiotics. Surgical intervention consists of the removal of necrotic or infected bone or associated tissues until grossly healthy, bleeding tissues are encountered ( 5 , 7 , 9 , 18 , 27 ). Based on the follow-up information, the results of this study show that the surgical debridement of ONJ sites combined with a course of oral antibiotics is a highly effective treatment modality in dogs.…”

Oronasal and Oroantral Fistulas Secondary to Periodontal Disease: A Retrospective Study Comparing the Prevalence Within Dachshunds and a Control Group

“…Recognizing that periodontal disease is the most common cause of acquired ONF/OAFs, alternative etiologies may include iatrogenic injury that manifests during tooth extraction, including avulsion of a portion of the palatal alveolar wall with the tooth during extraction, displacement of the tooth apex through the palatal alveolar wall during extraction, and exposure of nasoalveolar defects following extraction; postsurgical complications following procedures involving the palatine, incisive, and maxillary bones; iatrogenic surgical trauma; maxillofacial trauma; gunshot wounds; unsuccessful cleft lip/palate repair; neoplasia; electrical injury; eosinophilic granuloma; radiation therapy; pressure necrosis; complications associated with nasopharyngeal stents; and penetrating wounds. 1,4 -6,15 -18…”

“…An oronasal fistula (ONF) is an abnormal communication between the oral and nasal cavities. 1 An oroantral fistula (OAF) is an abnormal communication between the oral cavity and the maxillary recess. 2 The maxillary recess is located adjacent to the maxillary dentition distal to the maxillary third premolar.…”