Abstract
Bisphosphonate medications are widely prescribed for the treatment of osteoporosis and cancer metastases to bone. However, these medications are among a list of agents which are implicated in medication related osteonecrosis of the jaw (MRONJ). A variety of non-surgical and surgical approaches are indicated in the treatment of this condition, depending on disease severity.
Highlights
Medication related osteonecrosis of the jaw (MRONJ) is a condition that manifests as exposed, necrotic and non-healing jaw bone, in patients who have been treated with bisphosphonates, denosumab, chemotherapeutic agents, anti-angiogenic drugs, tyrosine kinase inhibitors, thalidomide and steroids [1,2,3,4]
Bisphosphonate medications are widely prescribed for the treatment of osteoporosis and cancer metastases to bone. These medications are among a list of agents which are implicated in medication related osteonecrosis of the jaw (MRONJ)
A variety of non-surgical and surgical approaches are indicated in the treatment of this condition, depending on disease severity. This case series demonstrates the success of the mylohyoid flap in combination with platelet rich fibrin (PRF) in achieving closure of necrotic bony defects
Summary
Medication related osteonecrosis of the jaw (MRONJ) is a condition that manifests as exposed, necrotic and non-healing jaw bone, in patients who have been treated with bisphosphonates, denosumab, chemotherapeutic agents, anti-angiogenic drugs, tyrosine kinase inhibitors, thalidomide and steroids [1,2,3,4]. Based on the staging and severity of the condition, MRONJ can be managed surgically and/or non-surgically [4]. The recommendations for surgical treatment of stage I and II MRONJ vary in the literature [8,9]. The aim of this case series is to present a surgical approach utilizing mylohyoid flap along with platelet rich fibrin (PRF) combined with antibiotics and chlorhexidine mouth wash to manage patients with stage II and advanced stage I MRONJ.
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