Vascularized fibula flap reconstruction of the mandible in bisphosphonate-related osteonecrosis

Nocini, P. F.; Saia, Giorgia; Bettini, Giordana; Ragazzo, M.; Blandamura, Stella; Chiarini, Luigi; Bedogni, Alberto

doi:10.1016/j.ejso.2008.05.002

Cited by 65 publications

(47 citation statements)

References 30 publications

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“…Nocini [56] reported incidence of BRONJ which was at least ten times higher in patients with malignancies than in those treated for osteoporosis for focal diseases. In compliment to the consequence of BRONJ, there was a major difference in morbidity between patients that received intravenous BPs compared to oral BPs.…”

Section: Management Of Bisphosphonates Related Osteonecrosis Of the Jmentioning

confidence: 99%

“…While in 2008, Nocini et al [56] reported that mandibular reconstruction with the fibula flap appeared to be appropriate in BRONJ resected patients and does not seem to influence the natural course of the primary disease. Another interesting finding in surgical management of BRONJ is transplantation of intralesional autologous bone marrow stem cell which shows complete response to the lesion [62].…”

Section: Management Of Bisphosphonates Related Osteonecrosis Of the Jmentioning

confidence: 99%

“…In compliment to the consequence of BRONJ, there was a major difference in morbidity between patients that received intravenous BPs compared to oral BPs. Majority of patients treated with IV BPs show permanent disability while those patients who received oral BPs had frequently healed from the complication [56,57]. Optimum management strategies of BRONJ is mostly palliative and empirical (to eliminate clinical symptoms like pain, infection and minimize the progression of bone necrosis) before microbial culture report [44,58].…”

Section: Management Of Bisphosphonates Related Osteonecrosis Of the Jmentioning

confidence: 99%

“…Treatments such as 0.12 % chlorhexidine gluconate mouth rinse (if exposed bone is painless), systemic antibiotics (if patient complains of pain and/or clinical evidence of infection) [56,57] conservative surgical debridement with or without primary flap closure as well as marginal or segmental resection [61] and HBO therapy [62][63][64] have been used. Some of these treatments are effective in patients while others are not effective and may even worsen their condition.…”

Section: Management Of Bisphosphonates Related Osteonecrosis Of the Jmentioning

confidence: 99%

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Bisphosphonate Related Osteonecrosis of the Jaw: An Update

Kumar¹,

Sinha²

2013

J. Maxillofac. Oral Surg.

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Objectives The aim of this paper is to summarize different diagnostic criteria as well as probable aetiopathogenesis of bisphosphonates related osteonecrosis of the jaw. Materials and MethodsThe electronic search of peerreviewed journals were performed in MEDLINE (PubMed) database in order to find the relevant articles on bisphosphonates related osteonecrosis of the jaw (BP-related ONJ). The search was restricted to English language articles, published from January 2002 to May 2013. On the basis of these articles, probable aetiopathogenesis and different diagnostic criteria of BP-related ONJ were summarized. Results BP-related ONJ is related to the development of avascular necrosis or dead jaw bones. In recent literature many given hypotheses show the aetiopathogenesis and diagnosis of BP-related ONJ which are interlinked and have multifactorial nature. Their diagnosis revolves around four main diagnostic criteria that differentiate it from other conditions which can delay bone healing. Conclusions Factors like potency of bisphosphonates, biology of jaw bone, antiangiogenic property of bisphosphonates and soft tissue toxicity in combination with present infection, other drugs, pre-existing pathologies, compromised immune response and dentoalveolar trauma may lead to development of BP-related ONJ.

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Section: Management Of Bisphosphonates Related Osteonecrosis Of the Jmentioning

confidence: 99%

Section: Management Of Bisphosphonates Related Osteonecrosis Of the Jmentioning

confidence: 99%

Section: Management Of Bisphosphonates Related Osteonecrosis Of the Jmentioning

confidence: 99%

Section: Management Of Bisphosphonates Related Osteonecrosis Of the Jmentioning

confidence: 99%

See 2 more Smart Citations

Bisphosphonate Related Osteonecrosis of the Jaw: An Update

Kumar¹,

Sinha²

2013

J. Maxillofac. Oral Surg.

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“…Several other small case series have collectively described 12 patients with a follow-up of 1 year or more treated in a similar fashion with fibula free flap reconstruction (Engroff and Kim, 2007;Nocini et al, 2009;Ferrari et al, 2008;Mucke et al, 2009). Postoperative complications included fistula (n=3), prolonged infection (n=1), and hematoma (n=1).…”

Section: Bisphosphonate-related Osteonecrosis Of the Jawmentioning

confidence: 99%

Mandibular Reconstruction with Vascularized Osseous Free Flaps: a Review of the Literature

Kim

Nam

et al. 2012

Asian Pacific Journal of Cancer Prevention

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Purpose: This article reviews a few of the commonly used types of vascularized osseous free flaps in maxillofacial reconstruction, which still represents the gold standard of restoration. We also discuss the developing concepts in maxillofacial reconstruction. Recent findings: Most of the literature reconfirms the established patterns of reconstruction with the aid of vascularized osseous free flaps. This method of freetissue transfer is also feasible in cases of osteoradionecrosis or bisphosphonate-related osteonecrosis of the jaw. These flaps are also suitable for prosthetic restoration using osseointegrated dental implants. Summary: Vascularized osseous free flaps still remain the standard of care. Improvements upon the free-tissue transfer method employing vascularized osseous free flaps, such as distraction osteogenesis, tissue engineering, and imaging techniques, currently require further development, but these technologies could lead to improved outcomes of maxillofacial reconstruction in the near future.

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Mandibulectomy and Free Flap Reconstruction for Bisphosphonate-Related Osteonecrosis of the Jaws

Hanasono

Militsakh

Richmon

et al. 2013

JAMA Otolaryngol Head Neck Surg

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Bisphosphonate-related osteonecrosis of the jaws is an increasingly recognized complication of intravenous and oral bisphosphonate therapy that can occasionally progress to involve full-thickness mandibular destruction, pathologic fracture, and fistulization, as well as chronic pain and infection. Mandibulectomy and free flap reconstruction is an effective treatment for patients with stage 3 and recalcitrant stage 2 bisphosphonate-related osteonecrosis of the jaws. High rates of chronic infection and underlying medical comorbidities may predispose to a substantial perioperative complication rate.

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Vascularized fibula flap reconstruction of the mandible in bisphosphonate-related osteonecrosis

Cited by 65 publications

References 30 publications

Bisphosphonate Related Osteonecrosis of the Jaw: An Update

Bisphosphonate Related Osteonecrosis of the Jaw: An Update

Mandibular Reconstruction with Vascularized Osseous Free Flaps: a Review of the Literature

Mandibulectomy and Free Flap Reconstruction for Bisphosphonate-Related Osteonecrosis of the Jaws

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