Skip to main content

Advertisement

SpringerLink
Log in

Bisphosphonate-associated osteonecrosis of the mandible: reliable soft tissue reconstruction using a local myofascial flap

  • Original Article
  • Published:
Clinical Oral Investigations Aims and scope Submit manuscript

Abstract

For the treatment of bisphosphonate-associated osteonecrosis of the jaw (BP-associated ONJ), poor cure rates are reported. In many cases, repeated osseous exposition and infection may occur. The currently recommended management of affected patients is antibiotic treatment and bony decortication, which is often complicated by soft tissue deficits due to chronic infection. In severe cases osteonecrosis can be managed often only by continuity resections of the mandible. For this purpose, we developed a new surgical procedure, which allows an effective closure of difficult jaw wounds in the lateral mandible. In the last 3 years, 20 patients with BP-associated osteonecrosis of the lower jaw were treated successfully with a modified defect-covering method using a myofascial flap. A mylohyoid muscle flap was detached from mylohyoid line and used to cover the bony defect. During 19 months mean follow-up, 90% of patients were asymptomatic, the oral mucosa was intact, and no exposed bone was observed. In consequence, we are able to demonstrate that a mylohyoid muscle flap provides a reliable wound closure in the lower jaw in patients treated with BPs. Although there are still no consensual therapy guidelines for patients affected by BP-associated ONJ, the results of the presented study provide evidence for an effective surgical therapy with long-term success. Covering compromised bone with well-vascularized tissue, a muscle flap, increased healing chances by enabling and supporting the necessary nutrition and defense against opportunistic infections. This therapy concept showed a good clinical outcome.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7

Similar content being viewed by others

References

  1. Marx RE (2003) Pamidronate (Aredia) and zoledronate (Zometa) induced avascular necrosis of the jaws: a growing epidemic. J Oral Maxillofac Surg 61:1115–1117

    Article  PubMed  Google Scholar 

  2. Vasikaran SD (2001) Bisphosphonates: an overview with special reference to alendronate. Ann Clin Biochem 38:608–623

    Article  PubMed  Google Scholar 

  3. Weitzman R, Sauter N, Eriksen EF, Tarassoff PG, Lacerna LV, Dias R, Altmeyer A, Csermak-Renner K, McGrath L, Lantwicki L, Hohneker JA (2007) Critical review: updated recommendations for the prevention, diagnosis, and treatment of osteonecrosis of the jaw in cancer patients—May 2006. Crit Rev Oncol Hematol 62:148–152. doi:10.1016/j.critrevonc.2006.12.005

    Article  PubMed  Google Scholar 

  4. Fleisch H (1998) Bisphosphonates: mechanisms of action. Endocr Rev 19:80–100

    Article  PubMed  Google Scholar 

  5. van Beek ER, Cohen LH, Leroy IM, Ebetino FH, Lowik CW, Papapoulos SE (2003) Differentiating the mechanisms of antiresorptive action of nitrogen containing bisphosphonates. Bone 33:805–811

    Article  PubMed  Google Scholar 

  6. Ruggiero SL, Dodson TB, Assael LA, Landesberg R, Marx RE, Mehrotra B, American Association of Oral and Maxillofacial Surgeons (2009) American Association of Oral and Maxillofacial Surgeons position paper on bisphosphonate-related osteonecrosis of the jaws—2009 update. J Oral Maxillofac Surg 67:2–12. doi:10.1016/j.joms.2009.01.009

    PubMed  Google Scholar 

  7. Ruggiero SL, Carlson ER, Assael LA (2009) Comprehensive review of bisphosphonate therapy: implications for the oral and maxillofacial surgery patient. J Oral Maxillofac Surg 67:1. doi:10.1016/j.joms.2009.03.001

    Article  PubMed  Google Scholar 

  8. Advisory Task Force on Bisphosphonate-Related Ostenonecrosis of the Jaws, American Association of Oral and Maxillofacial Surgeons (2007) American Association of Oral and Maxillofacial Surgeons position paper on bisphosphonate-related osteonecrosis of the jaws. J Oral Maxillofac Surg 65:369–376. doi:10.1016/j.joms.2006.11.003

    Article  Google Scholar 

  9. Chiandussi S, Biasotto M, Dore F, Cavalli F, Cova MA, Di Lenarda R (2006) Clinical and diagnostic imaging of bisphosphonate-associated osteonecrosis of the jaws. Dentomaxillofac Radiol 35:236–243. doi:10.1259/dmfr/27458726

    Article  PubMed  Google Scholar 

  10. Lo JC, O'Ryan FS, Gordon NP, Yang J, Hui RL, Martin D, Hutchinson M, Lathon PV, Sanchez G, Silver P, Chandra M, McCloskey CA, Staffa JA, Willy M, Selby JV, Go AS, Predicting Risk of Osteonecrosis of the Jaw with Oral Bisphosphonate Exposure (PROBE) Investigators (2010) Prevalence of osteonecrosis of the jaw in patients with oral bisphosphonate exposure. J Oral Maxillofac Surg 68:243–253. doi:10.1016/j.joms.2009.03.050

    Article  Google Scholar 

  11. Khosla S, Burr D, Cauley J, Dempster DW, Ebeling PR, Felsenberg D, Gagel RF, Gilsanz V, Guise T, Koka S, McCauley LK, McGowan J, McKee MD, Mohla S, Pendrys DG, Raisz LG, Ruggiero SL, Shafer DM, Shum L, Silverman SL, Van Poznak CH, Watts N, Woo SB, Shane E, American Society for Bone and Mineral Research (2007) Bisphosphonate-associated osteonecrosis of the jaw: report of a task force of the American Society for Bone and Mineral Research. J Bone Miner Res 22:1479–1491. doi:10.1359/jbmr.0707onj

    Article  PubMed  Google Scholar 

  12. Abu-Id MH, Warnke PH, Gottschalk J, Springer I, Wiltfang J, Acil Y, Russo PA, Kreusch T (2008) “Bis-phossy jaws”—high and low risk factors for bisphosphonate-induced osteonecrosis of the jaw. J Craniomaxillofac Surg 36:95–103. doi:10.1016/j.jcms.2007.06.008

    Article  PubMed  Google Scholar 

  13. Walter C, Al-Nawas B, Frickhofen N, Gamm H, Beck J, Reinsch L, Blum C, Grotz KA, Wagner W (2010) Prevalence of bisphosphonate associated osteonecrosis of the jaws in multiple myeloma patients. Head Face Med 6:11. doi:10.1186/1746-160X-6-11

    Article  PubMed  Google Scholar 

  14. Hoff AO, Toth BB, Altundag K, Johnson MM, Warneke CL, Hu M, Nooka A, Sayegh G, Guarneri V, Desrouleaux K, Cui J, Adamus A, Gagel RF, Hortobagyi GN (2008) Frequency and risk factors associated with osteonecrosis of the jaw in cancer patients treated with intravenous bisphosphonates. J Bone Miner Res 23:826–836. doi:10.1359/jbmr.080205

    Article  PubMed  Google Scholar 

  15. Mavrokokki T, Cheng A, Stein B, Goss A (2007) Nature and frequency of bisphosphonate-associated osteonecrosis of the jaws in Australia. J Oral Maxillofac Surg 65:415–423. doi:10.1016/j.joms.2006.10.061

    Article  PubMed  Google Scholar 

  16. Durie BG, Katz M, Crowley J (2005) Osteonecrosis of the jaw and bisphosphonates. N Engl J Med 353:99–102. doi:10.1056/NEJM200507073530120, discussion 99–102

    Article  PubMed  Google Scholar 

  17. Boonyapakorn T, Schirmer I, Reichart PA, Sturm I, Massenkeil G (2008) Bisphosphonate-induced osteonecrosis of the jaws: prospective study of 80 patients with multiple myeloma and other malignancies. Oral Oncol 44:857–869. doi:10.1016/j.oraloncology.2007.11.012

    Article  PubMed  Google Scholar 

  18. Badros A, Terpos E, Katodritou E, Goloubeva O, Kastritis E, Verrou E, Zervas K, Baer MR, Meiller T, Dimopoulos MA (2008) Natural history of osteonecrosis of the jaw in patients with multiple myeloma. J Clin Oncol 26:5904–5909. doi:10.1200/JCO.2008.16.9300

    Article  PubMed  Google Scholar 

  19. Bamias A, Kastritis E, Bamia C, Moulopoulos LA, Melakopoulos I, Bozas G, Koutsoukou V, Gika D, Anagnostopoulos A, Papadimitriou C, Terpos E, Dimopoulos MA (2005) Osteonecrosis of the jaw in cancer after treatment with bisphosphonates: incidence and risk factors. J Clin Oncol 23:8580–8587. doi:10.1200/JCO.2005.02.8670

    Article  PubMed  Google Scholar 

  20. Ruggiero SL, Fantasia J, Carlson E (2006) Bisphosphonate-related osteonecrosis of the jaw: background and guidelines for diagnosis, staging and management. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 102:433–441. doi:10.1016/j.tripleo.2006.06.004

    Article  PubMed  Google Scholar 

  21. Woo SB, Hellstein JW, Kalmar JR (2006) Narrative [corrected] review: bisphosphonates and osteonecrosis of the jaws. Ann Intern Med 144:753–761

    PubMed  Google Scholar 

  22. Otto S, Abu-Id MH, Fedele S, Warnke PH, Becker ST, Kolk A, Mucke T, Mast G, Kohnke R, Volkmer E, Haasters F, Lieger O, Iizuka T, Porter S, Campisi G, Colella G, Ploder O, Neff A, Wiltfang J, Ehrenfeld M, Kreusch T, Wolff KD, Sturzenbaum SR, Schieker M, Pautke C (2010) Osteoporosis and bisphosphonates-related osteonecrosis of the jaw: not just a sporadic coincidence—a multi-centre study. J Craniomaxillofac Surg. doi:10.1016/j.jcms.2010.05.009

  23. King AE, Umland EM (2008) Osteonecrosis of the jaw in patients receiving intravenous or oral bisphosphonates. Pharmacotherapy 28:667–677. doi:10.1592/phco.28.5.667

    Article  PubMed  Google Scholar 

  24. Rizzoli R, Burlet N, Cahall D, Delmas PD, Eriksen EF, Felsenberg D, Grbic J, Jontell M, Landesberg R, Laslop A, Wollenhaupt M, Papapoulos S, Sezer O, Sprafka M, Reginster JY (2008) Osteonecrosis of the jaw and bisphosphonate treatment for osteoporosis. Bone 42:841–847. doi:10.1016/j.bone.2008.01.003

    Article  PubMed  Google Scholar 

  25. Silverman SL, Landesberg R (2009) Osteonecrosis of the jaw and the role of bisphosphonates: a critical review. Am J Med 122:S33–S45. doi:10.1016/j.amjmed.2008.12.005

    Article  PubMed  Google Scholar 

  26. Marx RE, Sawatari Y, Fortin M, Broumand V (2005) Bisphosphonate-induced exposed bone (osteonecrosis/osteopetrosis) of the jaws: risk factors, recognition, prevention, and treatment. J Oral Maxillofac Surg 63:1567–1575. doi:10.1016/j.joms.2005.07.010

    Article  PubMed  Google Scholar 

  27. Reid IR (2009) Osteonecrosis of the jaw: who gets it, and why? Bone 44:4–10. doi:10.1016/j.bone.2008.09.012

    Article  PubMed  Google Scholar 

  28. Ruggiero SL (2009) Bisphosphonate-related osteonecrosis of the jaw (BRONJ): initial discovery and subsequent development. J Oral Maxillofac Surg 67:13–18. doi:10.1016/j.joms.2008.10.005

    Article  PubMed  Google Scholar 

  29. Scheper MA, Badros A, Chaisuparat R, Cullen KJ, Meiller TF (2009) Effect of zoledronic acid on oral fibroblasts and epithelial cells: a potential mechanism of bisphosphonate-associated osteonecrosis. Br J Haematol 144:667–676. doi:10.1111/j.1365-2141.2008.07504.x

    Article  PubMed  Google Scholar 

  30. Hoefert S, Schmitz I, Tannapfel A, Eufinger H (2009) Importance of microcracks in etiology of bisphosphonate-related osteonecrosis of the jaw: a possible pathogenetic model of symptomatic and non-symptomatic osteonecrosis of the jaw based on scanning electron microscopy findings. Clin Oral Investig. doi:10.1007/s00784-009-0300-6

  31. Sedghizadeh PP, Kumar SK, Gorur A, Schaudinn C, Shuler CF, Costerton JW (2008) Identification of microbial biofilms in osteonecrosis of the jaws secondary to bisphosphonate therapy. J Oral Maxillofac Surg 66:767–775. doi:10.1016/j.joms.2007.11.035

    Article  PubMed  Google Scholar 

  32. Sedghizadeh PP, Kumar SK, Gorur A, Schaudinn C, Shuler CF, Costerton JW (2009) Microbial biofilms in osteomyelitis of the jaw and osteonecrosis of the jaw secondary to bisphosphonate therapy. J Am Dent Assoc 140:1259–1265

    PubMed  Google Scholar 

  33. Lehrer S, Montazem A, Ramanathan L, Pessin-Minsley M, Pfail J, Stock RG, Kogan R (2009) Bisphosphonate-induced osteonecrosis of the jaws, bone markers, and a hypothesized candidate gene. J Oral Maxillofac Surg 67:159–161. doi:10.1016/j.joms.2008.09.015

    Article  PubMed  Google Scholar 

  34. Migliorati CA, Casiglia J, Epstein J, Jacobsen PL, Siegel MA, Woo SB (2005) Managing the care of patients with bisphosphonate-associated osteonecrosis: an American Academy of Oral Medicine position paper. J Am Dent Assoc 136:1658–1668

    PubMed  Google Scholar 

  35. Filleul O, Crompot E, Saussez S (2010) Bisphosphonate-induced osteonecrosis of the jaw: a review of 2,400 patient cases. J Cancer Res Clin Oncol 136:1117–1124. doi:10.1007/s00432-010-0907-7

    Article  PubMed  Google Scholar 

  36. Assael LA (2009) Oral bisphosphonates as a cause of bisphosphonate-related osteonecrosis of the jaws: clinical findings, assessment of risks, and preventive strategies. J Oral Maxillofac Surg 67:35–43. doi:10.1016/j.joms.2009.01.003

    Article  PubMed  Google Scholar 

  37. Fehm T, Felsenberg D, Krimmel M, Solomayer E, Wallwiener D, Hadjii P (2009) Bisphosphonate-associated osteonecrosis of the jaw in breast cancer patients: recommendations for prevention and treatment. Breast 18:213–217. doi:10.1016/j.breast.2009.07.001

    Article  PubMed  Google Scholar 

  38. Hess LM, Jeter JM, Benham-Hutchins M, Alberts DS (2008) Factors associated with osteonecrosis of the jaw among bisphosphonate users. Am J Med 121:475.e3–483.e3. doi:10.1016/j.amjmed.2008.01.047

    Article  Google Scholar 

  39. Aghaloo TL, Felsenfeld AL, Tetradis S (2010) Osteonecrosis of the jaw in a patient on Denosumab. J Oral Maxillofac Surg. doi:10.1016/j.joms.2009.10.010

  40. Van den Wyngaert T, Wouters K, Huizing MT, Vermorken JB (2011) RANK ligand inhibition in bone metastatic cancer and risk of osteonecrosis of the jaw (ONJ): non bis in idem? Support Care Cancer. doi:10.1007/s00520-010-1061-0

  41. Yarom N, Elad S, Madrid C, Migliorati CA (2010) Osteonecrosis of the jaws induced by drugs other than bisphosphonates—a call to update terminology in light of new data. Oral Oncol 46:e1. doi:10.1016/j.oraloncology.2009.10.004

    Article  PubMed  Google Scholar 

  42. Scoletta M, Arduino PG, Dalmasso P, Broccoletti R, Mozzati M (2010) Treatment outcomes in patients with bisphosphonate-related osteonecrosis of the jaws: a prospective study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 110:46–53. doi:10.1016/j.tripleo.2010.02.020

    Article  PubMed  Google Scholar 

  43. Van den Wyngaert T, Claeys T, Huizing MT, Vermorken JB, Fossion E (2009) Initial experience with conservative treatment in cancer patients with osteonecrosis of the jaw (ONJ) and predictors of outcome. Ann Oncol 20:331–336. doi:10.1093/annonc/mdn630

    Article  PubMed  Google Scholar 

  44. Fantasia JE (2009) Bisphosphonates—what the dentist needs to know: practical considerations. J Oral Maxillofac Surg 67:53–60. doi:10.1016/j.joms.2009.01.011

    Article  PubMed  Google Scholar 

  45. Ruggiero SL (2010) Bisphosphonate-related osteonecrosis of the jaw: an overview. Ann N Y Acad Sci. doi:10.1111/j.1749-6632.2010.05768.x;10.1111/j.1749-6632.2010.05768.x

  46. Knight RJ, Reddy C, Rtshiladze MA, Lvoff G, Sherring D, Marucci D (2010) Bisphosphonate-related osteonecrosis of the jaw: tip of the iceberg. J Craniofac Surg 21:25–32. doi:10.1097/SCS.0b013e3181c347a0

    Article  PubMed  Google Scholar 

  47. Rayman S, Almas K, Dincer E (2009) Bisphosphonate-related jaw necrosis: a team approach management and prevention. Int J Dent Hyg 7:90–95

    Article  PubMed  Google Scholar 

  48. Mucke T, Koschinski J, Deppe H, Wagenpfeil S, Pautke C, Mitchell DA, Wolff KD, Holzle F (2010) Outcome of treatment and parameters influencing recurrence in patients with bisphosphonate-related osteonecrosis of the jaws. J Cancer Res Clin Oncol. doi:10.1007/s00432-010-0953-1

  49. Carlson ER, Basile JD (2009) The role of surgical resection in the management of bisphosphonate-related osteonecrosis of the jaws. J Oral Maxillofac Surg 67:85–95. doi:10.1016/j.joms.2009.01.006

    Article  PubMed  Google Scholar 

  50. Trauner R (1952) Alveoloplasty with ridge extensions on the lingual side of the lower jaw to solve the problem of a lower dental prosthesis. Oral Surg Oral Med Oral Pathol 5:340–346

    Article  PubMed  Google Scholar 

  51. Trauner R (1965) 10 year results of mylohyoid plastic surgery. Fortschr Kiefer Gesichtschir 10:23–28

    PubMed  Google Scholar 

  52. Body JJ (2006) Breast cancer: bisphosphonate therapy for metastatic bone disease. Clin Cancer Res 12:6258s–6263s. doi:10.1158/1078-0432.CCR-06-0840

    Article  PubMed  Google Scholar 

  53. Bagger YZ, Tanko LB, Alexandersen P, Ravn P, Christiansen C (2003) Alendronate has a residual effect on bone mass in postmenopausal Danish women up to 7 years after treatment withdrawal. Bone 33:301–307

    Article  PubMed  Google Scholar 

  54. Harper RP, Fung E (2007) Resolution of bisphosphonate-associated osteonecrosis of the mandible: possible application for intermittent low-dose parathyroid hormone [rhPTH(1–34)]. J Oral Maxillofac Surg 65:573–580. doi:10.1016/j.joms.2006.10.076

    Article  PubMed  Google Scholar 

  55. Lin JH (1996) Bisphosphonates: a review of their pharmacokinetic properties. Bone 18:75–85

    Article  PubMed  Google Scholar 

  56. Vescovi P, Manfredi M, Merigo E, Meleti M, Fornaini C, Rocca JP, Nammour S (2010) Surgical approach with Er:YAG laser on osteonecrosis of the jaws (ONJ) in patients under bisphosphonate therapy (BPT). Lasers Med Sci 25:101–113. doi:10.1007/s10103-009-0687-y

    Article  PubMed  Google Scholar 

  57. Marx RE, Cillo JE Jr, Ulloa JJ (2007) Oral bisphosphonate-induced osteonecrosis: risk factors, prediction of risk using serum CTX testing, prevention, and treatment. J Oral Maxillofac Surg 65:2397–2410. doi:10.1016/j.joms.2007.08.003

    Article  PubMed  Google Scholar 

  58. Dimopoulos MA, Kastritis E, Bamia C, Melakopoulos I, Gika D, Roussou M, Migkou M, Eleftherakis-Papaiakovou E, Christoulas D, Terpos E, Bamias A (2009) Reduction of osteonecrosis of the jaw (ONJ) after implementation of preventive measures in patients with multiple myeloma treated with zoledronic acid. Ann Oncol 20:117–120. doi:10.1093/annonc/mdn554

    Article  PubMed  Google Scholar 

  59. Ripamonti CI, Maniezzo M, Campa T, Fagnoni E, Brunelli C, Saibene G, Bareggi C, Ascani L, Cislaghi E (2009) Decreased occurrence of osteonecrosis of the jaw after implementation of dental preventive measures in solid tumour patients with bone metastases treated with bisphosphonates. The experience of the National Cancer Institute of Milan. Ann Oncol 20:137–145. doi:10.1093/annonc/mdn526

    Article  PubMed  Google Scholar 

  60. Gallego L, Junquera L (2009) Consequence of therapy discontinuation in bisphosphonate-associated osteonecrosis of the jaws. Br J Oral Maxillofac Surg 47:67–68. doi:10.1016/j.bjoms.2008.05.011

    Article  PubMed  Google Scholar 

  61. Coxon FP, Thompson K, Roelofs AJ, Ebetino FH, Rogers MJ (2008) Visualizing mineral binding and uptake of bisphosphonate by osteoclasts and non-resorbing cells. Bone 42:848–860. doi:10.1016/j.bone.2007.12.225

    Article  PubMed  Google Scholar 

  62. McMahon RE, Bouquot JE, Glueck CJ, Spolnik KJ, Adams WR (2004) Osteonecrosis: a multifactorial etiology. J Oral Maxillofac Surg 62:904–905

    Article  PubMed  Google Scholar 

  63. Kapitola J, Zak J, Justova V, Lacinova Z (2002) Effect of pamidronate on bone blood flow and serum levels of IGF-I in sham-operated and oophorectomized female rats. Sb Lek 103:455–460

    PubMed  Google Scholar 

  64. Fournier P, Boissier S, Filleur S, Guglielmi J, Cabon F, Colombel M, Clezardin P (2002) Bisphosphonates inhibit angiogenesis in vitro and testosterone-stimulated vascular regrowth in the ventral prostate in castrated rats. Cancer Res 62:6538–6544

    PubMed  Google Scholar 

  65. Wutzl A, Biedermann E, Wanschitz F, Seemann R, Klug C, Baumann A, Watzinger F, Schicho K, Ewers R, Millesi G (2008) Treatment results of bisphosphonate-related osteonecrosis of the jaws. Head Neck 30:1224–1230. doi:10.1002/hed.20864

    Article  PubMed  Google Scholar 

  66. Elad S, Gomori MJ, Ben-Ami N, Friedlander-Barenboim S, Regev E, Lazarovici TS, Yarom N (2010) Bisphosphonate-related osteonecrosis of the jaw: clinical correlations with computerized tomography presentation. Clin Oral Investig 14:43–50. doi:10.1007/s00784-009-0311-3

    Article  PubMed  Google Scholar 

  67. Van den Wyngaert T, Huizing MT, Vermorken JB (2007) Osteonecrosis of the jaw related to the use of bisphosphonates. Curr Opin Oncol 19:315–322. doi:10.1097/CCO.0b013e32819f820b

    Article  PubMed  Google Scholar 

  68. Montebugnoli L, Felicetti L, Gissi DB, Pizzigallo A, Pelliccioni GA, Marchetti C (2007) Biphosphonate-associated osteonecrosis can be controlled by nonsurgical management. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 104:473–477. doi:10.1016/j.tripleo.2007.01.008

    Article  PubMed  Google Scholar 

  69. Migliorati CA, Schubert MM, Peterson DE, Seneda LM (2005) Bisphosphonate-associated osteonecrosis of mandibular and maxillary bone: an emerging oral complication of supportive cancer therapy. Cancer 104:83–93. doi:10.1002/cncr.21130

    Article  PubMed  Google Scholar 

  70. Diego R, D'Orto O, Pagani D, Agazzi A, Marzano U, Derada Troletti G, Fontanella W, Pignataro L (2007) Bisphosphonate-associated osteonecrosis of the jaws: a therapeutic dilemma. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 103:e1–e5. doi:10.1016/j.tripleo.2006.09.022

    PubMed  Google Scholar 

  71. Stockmann P, Vairaktaris E, Wehrhan F, Seiss M, Schwarz S, Spriewald B, Neukam FW, Nkenke E (2009) Osteotomy and primary wound closure in bisphosphonate-associated osteonecrosis of the jaw: a prospective clinical study with 12 months follow-up. Support Care Cancer. doi:10.1007/s00520-009-0688-1

  72. Pautke C, Bauer F, Tischer T, Kreutzer K, Weitz J, Kesting M, Holzle F, Kolk A, Sturzenbaum SR, Wolff KD (2009) Fluorescence-guided bone resection in bisphosphonate-associated osteonecrosis of the jaws. J Oral Maxillofac Surg 67:471–476. doi:10.1016/j.joms.2008.09.037

    Article  PubMed  Google Scholar 

  73. Wilde F, Heufelder M, Winter K, Hendricks J, Frerich B, Schramm A, Hemprich A (2010) The role of surgical therapy in the management of intravenous bisphosphonates-related osteonecrosis of the jaw. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. doi:10.1016/j.tripleo.2010.04.015

  74. Alons K, Kuijpers SC, de Jong E, van Merkesteyn JP (2009) Treating low- and medium-potency bisphosphonate-related osteonecrosis of the jaws with a protocol for the treatment of chronic suppurative osteomyelitis: report of 7 cases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 107:e1–e7. doi:10.1016/j.tripleo.2008.09.021

    PubMed  Google Scholar 

  75. Stanton DC, Balasanian E (2009) Outcome of surgical management of bisphosphonate-related osteonecrosis of the jaws: review of 33 surgical cases. J Oral Maxillofac Surg 67:943–950. doi:10.1016/j.joms.2008.12.057

    Article  PubMed  Google Scholar 

  76. Bedogni A, Blandamura S, Lokmic Z, Palumbo C, Ragazzo M, Ferrari F, Tregnaghi A, Pietrogrande F, Procopio O, Saia G, Ferretti M, Bedogni G, Chiarini L, Ferronato G, Ninfo V, Lo Russo L, Lo Muzio L, Nocini PF (2008) Bisphosphonate-associated jawbone osteonecrosis: a correlation between imaging techniques and histopathology. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 105:358–364. doi:10.1016/j.tripleo.2007.08.040

    Article  PubMed  Google Scholar 

  77. Freiberger JJ, Padilla-Burgos R, Chhoeu AH, Kraft KH, Boneta O, Moon RE, Piantadosi CA (2007) Hyperbaric oxygen treatment and bisphosphonate-induced osteonecrosis of the jaw: a case series. J Oral Maxillofac Surg 65:1321–1327. doi:10.1016/j.joms.2007.03.019

    Article  PubMed  Google Scholar 

  78. Agrillo A, Ungari C, Filiaci F, Priore P, Iannetti G (2007) Ozone therapy in the treatment of avascular bisphosphonate-related jaw osteonecrosis. J Craniofac Surg 18:1071–1075. doi:10.1097/scs.0b013e31857261f

    Article  PubMed  Google Scholar 

  79. Madrid C, Bouferrache K, Abarca M, Jaques B, Broome M (2010) Bisphosphonate-related osteonecrosis of the jaws: how to manage cancer patients. Oral Oncol 46:468–470. doi:10.1016/j.oraloncology.2010.03.016

    Article  PubMed  Google Scholar 

  80. Pautke C, Bauer F, Otto S, Tischer T, Steiner T, Weitz J, Kreutzer K, Hohlweg-Majert B, Wolff KD, Hafner S, Mast G, Ehrenfeld M, Sturzenbaum SR, Kolk A (2011) Fluorescence-guided bone resection in bisphosphonate-related osteonecrosis of the jaws: first clinical results of a prospective pilot study. J Oral Maxillofac Surg 69:84–91. doi:10.1016/j.joms.2010.07.014

    Article  PubMed  Google Scholar 

  81. Engroff SL, Kim DD (2007) Treating bisphosphonate osteonecrosis of the jaws: is there a role for resection and vascularized reconstruction? J Oral Maxillofac Surg 65:2374–2385. doi:10.1016/j.joms.2006.07.012

    Article  PubMed  Google Scholar 

  82. Engroff SL, Coletti D (2008) Bisphosphonate related osteonecrosis of the palate: report of a case managed with free tissue transfer. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 105:580–582. doi:10.1016/j.tripleo.2007.11.025

    Article  PubMed  Google Scholar 

  83. Ferrari S, Bianchi B, Savi A, Poli T, Multinu A, Balestreri A, Ferri A (2008) Fibula free flap with endosseous implants for reconstructing a resected mandible in bisphosphonate osteonecrosis. J Oral Maxillofac Surg 66:999–1003. doi:10.1016/j.joms.2007.06.631

    Article  PubMed  Google Scholar 

Download references

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Cranio- and Maxillofacial Surgery, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625, Hannover, Germany

    Juliana Lemound, Andrè Eckardt, Horst Kokemüller, Constantin von See, Frank Tavassol, Martin Rücker, Majeed Rana & Nils-Claudius Gellrich

  2. Department of Oral and Maxillofacial Surgery, University Hospital Freiburg, Hugstetterstr. 55, 79106, Freiburg, Germany

    Pit Jacob Voss

Authors
  1. Juliana Lemound
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Andrè Eckardt
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Horst Kokemüller
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Constantin von See
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Pit Jacob Voss
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Frank Tavassol
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Martin Rücker
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Majeed Rana
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Nils-Claudius Gellrich
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Juliana Lemound.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Lemound, J., Eckardt, A., Kokemüller, H. et al. Bisphosphonate-associated osteonecrosis of the mandible: reliable soft tissue reconstruction using a local myofascial flap. Clin Oral Invest 16, 1143–1152 (2012). https://doi.org/10.1007/s00784-011-0596-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00784-011-0596-x

Keywords

Search

Navigation