Immediate reconstruction after segmental mandiblectomy in a patient with refractory osteomyelitis of the jaw caused by oral bisphosphonate therapy

  • ASAKA Takuya
    Department of Oral Surgery, Hokuto Hospital Oral Diagnosis and Medicine, Department of Oral Pathobiological Science, Graduate School of Dental Medicine, Hokkaido University
  • MAKINO Shujiroh
    Department of Oral Surgery, Hokuto Hospital
  • TAKANO Masashi
    Department of Oral Surgery, Hokuto Hospital
  • ABE Takahiro
    Department of Oral Surgery, Hokuto Hospital Oral Diagnosis and Medicine, Department of Oral Pathobiological Science, Graduate School of Dental Medicine, Hokkaido University
  • ABIKO Yoshihiro
    Department of Dental Science, Division of Oral Medicine & Pathology, Institute of Personalized Medical Science, Health Sciences University of Hokkaido
  • KITAGAWA Yoshimasa
    Oral Diagnosis and Medicine, Department of Oral Pathobiological Science, Graduate School of Dental Medicine, Hokkaido University

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Other Title
  • ビスフォスフォネート製剤内服患者に発症した難治性下顎骨骨髄炎に対して下顎区域切除・即時再建術を行った1例
  • ビスフォスフォネート セイザイ ナイフク カンジャ ニ ハッショウ シタ ナンチセイ カガクコツ コツズイエン ニ タイシテ カガク クイキ セツジョ ・ ソクジ サイケンジュツ オ オコナッタ 1レイ

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Abstract

Recently, segmental mandiblectomy has been increasingly used to treat advanced cases of bisphosphonate-related osteonecrosis of the jaws (BRONJ), and titanium plates have been recommended for mandibular reconstruction. To date, only a few patients have undergone immediate reconstruction with a free- bone flap. We describe a patient with refractory osteomyelitis of the jaw caused by oral bisphosphonates in whom immediate reconstruction with a free-fibula flap was performed after segmental mandiblectomy. At present, 19 months after the operation, there has been no clinical or radiographic evidence of recurrent osteomyelitis or BRONJ, and computed tomography showed good osseous integration.

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