Abstract
Abstract: The aim of this paper is to present the case of a 73 year old man with immediate implants who was admitted to the Clinic of Maxillofacial Surgery for treatment of medication-related osteonecrosis of the upper right jaw. The problem occurred after the extraction of two teeth, without considering that the patient is undergoing chemotherapy with Xgeva. The patient was diagnosed with prostate cancer in 2013. In 2015 were found metastases on the bones. According to the particular characteristics of the patient he underwent surgery under general anesthesia. The innovation in our case is that we used a placement of a PRF membrane and plastic closure of the wound. This is a new and alternative treatment method and there were no postoperative complications or wound infections, which are usually common in the postoperative period for people with medication-related osteonecrosis of the jaws.
Highlights
The American association of oral and maxillofacial surgeons (AAOMS) defines the Мedication-related osteonecrosis of the jaws as the presence of open necrotic bone in the maxillofacial area that does not heal for more than 8 weeks and affects patients who have cancer and have undergone long-term intravenous treatment with bisphosphonates, denosumab and/or anti-angiogenic drugs, but without a history of jaw radiation therapy.[1,2,3,4,5,6] Open necrotic bone in the oral cavity is only one of the possible manifestations of the disease and it does not occur in all patients
The risk of Medication-related osteonecrosis of the jaws (MRONJ) in cancer patients on bisphosphonates therapy is approximately 1% (100 cases per 10,000 patients) and almost the same is the risk for patients on RANKL inhibiting treatment with denosumab.[10]
The most effective approach in cancer patients is the prevention of MRONJ
Summary
The American association of oral and maxillofacial surgeons (AAOMS) defines the Мedication-related osteonecrosis of the jaws as the presence of open necrotic bone in the maxillofacial area that does not heal for more than 8 weeks and affects patients who have cancer and have undergone long-term intravenous treatment with bisphosphonates, denosumab and/or anti-angiogenic drugs, but without a history of jaw radiation therapy.[1,2,3,4,5,6] Open necrotic bone in the oral cavity is only one of the possible manifestations of the disease and it does not occur in all patients. The incidence of MRONJ is twice as high in the mandible (77%) as in the maxilla and higher in women (72%) than in men.[9] The risk of MRONJ in cancer patients on bisphosphonates therapy is approximately 1% (100 cases per 10,000 patients) and almost the same is the risk for patients on RANKL inhibiting treatment with denosumab.[10] In addition to the medication-related, there are other risk factors, such as local ones – tooth extraction or other dentoalveolar procedures, as well as demographic and systemic ones – age, sex, corticosteroids, tobacco use, etc.[11] MRONJ has a negative effect on quality of life, and can result in reduced social contact, pain and masticatory difficulties.[10]
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