Evidence map›Paper›PMID 29977926›Full record

SynthesisBioMed research international2018

Microsurgical Reconstruction of the Jaws Using Vascularised Free Flap Technique in Patients with Medication-Related Osteonecrosis: A Systematic Review.

Roberto Sacco, Nicola Sacco, Umar Hamid, Syed Hasan Ali, Mark Singh, John St J Blythe

Open access · hybridAbstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BioMed research international, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
16citing papers in PubMed, 1 pooled it
1.4field-weighted citation impact, top 15% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

16 citing papers in PubMed, 1 synthesis or guideline pooled it, 45 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Prevalence and risk factors of MRONJ in breast cancer patients with CTIBL.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025
    Article
  5. Article
  6. Implementation of MedicalholodeckHealthcare (Basel, Switzerland) · 2025
    Article
  7. How we manage medication-related osteonecrosis of the jaw.European journal of medical research · 2024
    Review
  8. Review
  9. Article
  10. Article
  11. Review
  12. Article
  13. Review
  14. Article
  15. Article
  16. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 5 institutions in 2 countries.

Roberto SaccoBarts and The London School of Medicine and Dentistry, London, UK.ORCID 0000-0002-8413-1053
Nicola SaccoDepartment of Anaesthesiology, Resuscitation and Intensive Care Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy.
Umar HamidKing's College Hospital, London, UK.
Syed Hasan AliKing's College Hospital, London, UK.
Mark SinghMid Essex Hospital Service NHS Trust, Chelmsford, UK.
John St J BlytheBart's and The London NHS Trust, London, UK.
King's College Hospital · GBBarts Health NHS Trust · GBMid Essex Hospital Services NHS Trust · GBQueen Mary University of London · GBUniversity of Campania "Luigi Vanvitelli" · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundOsteonecrosis of the jaw (ONJ) has been reported to be associated with patients receiving primarily bisphosphonate (BP) therapies. However, lately it has been documented that other medications, such as RANK ligand inhibitor (denosumab) and antiangiogenic drug, can cause ONJ. Micro-osseous-vascular reconstruction of the jaws in patients affected by medication-related osteonecrosis of the jaw represents a viable option of treatment for patients affected by stage III of the disease. However, there are still considerable doubts about the success of this procedure in the short, medium, and long term. MATERIAL AND

methodsA multidatabase (PubMed/MEDLINE, EMBASE, and CENTRAL) systematic search was performed. Any type of studies considering human patients treated with antiresorptive and antiangiogenic drugs was considered. The aim of the research is to primarily understand the success rate of micro-osseous-vascular reconstruction in the short, medium, and long period of time. This review has also the goal of better understanding any perioperative and postoperative complications resulting from the use of the reconstruction techniques.

resultsEighteen studies resulted eligible for the study. Fibula free flap is the most commonly utilised vascularised free flap reconstruction technique (80.76%). Ten out of eighteen studies reported no complications. Recurrence of osteonecrosis was registered in five cases (6.41%) after free flap reconstruction. The overall free flap success rate was 96.16%.

conclusionsBased on the limited data available in literature (Level 4 of the Oxford Evidence-based medicine scale), micro-osseous-vascular reconstruction of the jaws represents a valid treatment in patients with bisphosphonate-related osteonecrosis at stage III of the disease. However, additional data based on a larger cohort of patients are necessary to justify this type of intervention in patient affected by MRONJ.

Indexed as

Free Tissue FlapsAgedBisphosphonate-Associated Osteonecrosis of the JawBone Density Conservation AgentsDenosumabDiphosphonatesFemaleFibulaHumansMaleMicrosurgeryMiddle AgedOsteonecrosisRetrospective StudiesBone Density Conservation AgentsDenosumabDiphosphonates

Identifiers

PMID29977926
PMCPMC6011121
OpenAlexW2805977304

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.