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Surgical treatment of 61 consecutive patients with maxillary stage 3 medication–related osteonecrosis of the jaws using a pedicled buccal fat pad

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Abstract

Purpose

Buccal fat pad (BFP) is used for the closure of large oroantral defects caused by surgical removal of the necrotic bone in patients with medication-related osteonecrosis of the jaw (MRONJ). This study aimed to evaluate the use of BFP for the closure of maxillary sinus defects in stage 3 MRONJ patients.

Methods

This study recruited 61patients with large oroantral defects caused by MRONJ, including 49 patients with cancer and 12 patients with osteoporosis. Lesions were evaluated clinically and radiographically.

Results

Among the 61 patients, 51 (83.6%) healed uneventfully, and 5 patients (8.2%) had local dehiscence and exposed bone; these 56 patients (91.8%) all healed after first or second operation. The Eastern Cooperative Oncology Group Performance Status was associated with being non-cured and might be an indicator for the healing process. All patients experienced a significant increase in body weight postoperatively.

Conclusions

This study suggest that block resection with removal of the necrotic bone combined with radical sinusotomy and closure of the defect with BFP is a reliable method to cure MRONJ lesions with a high success rate, and successful operation and prosthetic rehabilitation may improve body weight and the quality of life.

The study was approved by the appropriate ethical approval for the Copenhagen ONJ Cohort (protocol no. H-6–2013-010) November 20, 2013.

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Author information

Authors and Affiliations

  1. Department of Oral & Maxillofacial Surgery, Copenhagen University Hospital, Blegdamsvej 9, 2100, Copenhagen, Denmark

    Sanne Werner Moeller Andersen, Ditte Gertz Mogensen, Morten Schioedt & Thomas Kofod

  2. Department of Clinical Epidemiology, Aarhus University Hospital, Olof Palmes Allé 43-45, 8200, Aarhus, Denmark

    Morten Schioedt

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  1. Sanne Werner Moeller Andersen
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  2. Ditte Gertz Mogensen
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  3. Morten Schioedt
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Contributions

Sanne Werner Moeller Andersen: conceptualization, data curation, formal analysis, investigation, methodology, project administration, supervision, validation, visualization, writing original draft, writing review, and editing.

Ditte Gertz Mogensen: conceptualization, data curation, formal analysis, investigation, methodology, project administration, software, validation, writing original draft, writing review, and editing.

Morten Schiodt: conceptualization, data curation, formal analysis, investigation, methodology, project administration, resources, supervision, validation, visualization.

Thomas Kofod: conceptualization, investigation, resources, supervision, validation, writing review, and editing.

Corresponding author

Correspondence to Sanne Werner Moeller Andersen.

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Ethics approval

Ethic committee H-6–2013-010 November 20, 2013.

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All patients signed an informed consent.

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Not applicable.

Conflict of interest

Morten Schiodt has been a consultant for Amgen. Other authors have no conflicts of interest to declare.

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Morten Schioedt passed away before the submission

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Andersen, S.W.M., Mogensen, D.G., Schioedt, M. et al. Surgical treatment of 61 consecutive patients with maxillary stage 3 medication–related osteonecrosis of the jaws using a pedicled buccal fat pad. Oral Maxillofac Surg 27, 251–261 (2023). https://doi.org/10.1007/s10006-022-01061-2

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  • DOI: https://doi.org/10.1007/s10006-022-01061-2

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