ArticleHua xi kou qiang yi xue za zhi = Huaxi kouqiang yixue zazhi = West China journal of stomatology2022
Clinical application of double-layer soft tissue closure technology based on pedicled buccal fat pad in repairing maxillary defects after medication-related osteonecrosis of jaw surgery.
Article in Hua xi kou qiang yi xue za zhi = Huaxi kouqiang yixue zazhi = West China journal of stomatology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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2 citing papers in PubMed, 1 citations in OpenAlex.
- Chinese expert consensus on the diagnosis and clinical management of medication-related osteonecrosis of the jaw.Journal of bone oncology · 2024Review
- Surgical treatment of severe medication-related osteonecrosis of the jaw.Hua xi kou qiang yi xue za zhi = Huaxi kouqiang yixue zazhi = West China journal of stomatology · 2023Article
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5 authors at 1 institution in 2 countries.
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Abstract
objectivesThis study aimed to analyze the clinical application effect of the double-layer soft tissue closure technique (DLST) based on pedicled buccal fat pad in repairing maxillary defects after medication-related osteonecrosis of the jaw (MRONJ) surgery.
methodsTen patients with maxillary MRONJ were diagnosed and treated via DLST based on pedicled buccal fat pad. Partial maxillary resection was conducted to remove the MRONJ lesion, and the inflammatory soft tissue in the maxillary sinus cavity was removed but the maxillary sinus mucosa was retained. Patients also underwent resection of the lower segment of the sphenoid pterygoid process. A pedicled buccal fat pad was used to line the maxillary sinus floor and oral mucosa to achieve double-layer soft tissue closure of the wound. The characteristics of the medication for the primary disease, the clinical characteristics and imaging characteristics of osteonecrosis, the surgical treatment effects, pain score, and functional status evaluation of the 10 patients were all reviewed and analyzed.
resultsAmong the 10 patients, there were 5 cases of breast cancer, 2 cases of lung cancer, 1 case of prostate cancer, 1 case of multiple myeloma, and 1 case of kidney cancer. All 10 patients received zoledronic acid, and the average time of application of zoledronic acid was 34 months. Six patients had upper jaw exposure, and 4 patients had gingival soft tissue fistula; the average time to clinical symptoms was 5.6 months. Among them, 5 patients had a history of tooth extraction, 3 patients with apical periodontitis, 1 patient with periodontitis, and 1 patient with spontaneous teeth loss. The lesions of 10 patients were all located in the maxillary posterior area. CT images can often show sequestration near the maxillary sinus floor, and the maxillary sinus cavity was full of soft tissue inflammation in most patients. During the follow-up period, 8 patients healed by the first intention, and the other patient had partial liquefaction of the buccal fat pad 2 weeks after the operation, and the oral mucosa fistula closed 1 month after the operation. In another patient, MRONJ symptoms recurred 2 months after the operation, and the surgical site occasionally swelled and discharged pus. The patient's symptoms were completely relieved after another operation. The patient's pain and functional status improved significantly after the operation.
conclusionsMaxillary MRONJ is commonly found in the posterior area. The buccal fat pad-based DLST is used to repair the defect after maxillary resection, which is beneficial to seal the oral-maxillary sinus fistula and improve the clinical symptoms of patients with MRONJ.
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