Reconstruction of Defect after Treatment of Bisphosphonate-related Osteonecrois of the Jaw with Staged Iliac Bone Graft
Identifieur interne : 000185 ( Pmc/Curation ); précédent : 000184; suivant : 000186Reconstruction of Defect after Treatment of Bisphosphonate-related Osteonecrois of the Jaw with Staged Iliac Bone Graft
Auteurs : Kyo-Jin Ahn ; Young-Kyun Kim ; Pil-Young YunSource :
- Maxillofacial Plastic and Reconstructive Surgery [ 2288-8101 ] ; 2014.
Abstract
Bisphosphonate is used widely for osteoporosis treatment, but a rising concern is the risk of osteonecrosis after long-term bisphosphonate use. Such cases are increasing, suggesting a need for research to prevent and treat bisphosphonate-related osteonecrosis of jaws. A 63-year-old female took bisphosphonate (Fosamax®) for four years for treatment of osteoporosis and stopped medication two months ago because of unhealed wound. She was treated with marginal mandibulectomy maintaining the inferior border, and a metal plate was placed to prevent mandible fracture. Four months after the mandibulectomy, mandible reconstruction surgery using iliac bone and allograft was done. Six months after reconstruction, implant placement and treatment with an overdenture was done without complications. This study presents a case with a successful result.
Url:
DOI: 10.14402/jkamprs.2014.36.2.57
PubMed: 27489811
PubMed Central: 4281905
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<author><name sortKey="Ahn, Kyo Jin" sort="Ahn, Kyo Jin" uniqKey="Ahn K" first="Kyo-Jin" last="Ahn">Kyo-Jin Ahn</name>
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<author><name sortKey="Kim, Young Kyun" sort="Kim, Young Kyun" uniqKey="Kim Y" first="Young-Kyun" last="Kim">Young-Kyun Kim</name>
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<front><div type="abstract" xml:lang="en"><p>Bisphosphonate is used widely for osteoporosis treatment, but a rising concern is the risk of osteonecrosis after long-term bisphosphonate use. Such cases are increasing, suggesting a need for research to prevent and treat bisphosphonate-related osteonecrosis of jaws. A 63-year-old female took bisphosphonate (Fosamax<sup>®</sup>
) for four years for treatment of osteoporosis and stopped medication two months ago because of unhealed wound. She was treated with marginal mandibulectomy maintaining the inferior border, and a metal plate was placed to prevent mandible fracture. Four months after the mandibulectomy, mandible reconstruction surgery using iliac bone and allograft was done. Six months after reconstruction, implant placement and treatment with an overdenture was done without complications. This study presents a case with a successful result.</p>
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<pmc article-type="case-report"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Maxillofac Plast Reconstr Surg</journal-id>
<journal-id journal-id-type="iso-abbrev">Maxillofac Plast Reconstr Surg</journal-id>
<journal-id journal-id-type="publisher-id">MPRS</journal-id>
<journal-title-group><journal-title>Maxillofacial Plastic and Reconstructive Surgery</journal-title>
</journal-title-group>
<issn pub-type="ppub">2288-8101</issn>
<issn pub-type="epub">2288-8586</issn>
<publisher><publisher-name>The Korean Association of Maxillofacial Plastic and Reconstructive Surgeons</publisher-name>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">27489811</article-id>
<article-id pub-id-type="pmc">4281905</article-id>
<article-id pub-id-type="doi">10.14402/jkamprs.2014.36.2.57</article-id>
<article-id pub-id-type="publisher-id">mprs-36-057</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Case Report</subject>
</subj-group>
</article-categories>
<title-group><article-title>Reconstruction of Defect after Treatment of Bisphosphonate-related Osteonecrois of the Jaw with Staged Iliac Bone Graft</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Ahn</surname>
<given-names>Kyo-Jin</given-names>
</name>
</contrib>
<contrib contrib-type="author"><name><surname>Kim</surname>
<given-names>Young-Kyun</given-names>
</name>
<xref ref-type="corresp" rid="c1-mprs-36-057"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Yun</surname>
<given-names>Pil-Young</given-names>
</name>
</contrib>
<aff id="af1-mprs-36-057">Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul National University Bundang Hospital</aff>
</contrib-group>
<author-notes><corresp id="c1-mprs-36-057">Correspondence to <bold>Young-Kyun Kim</bold>
, Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul National University Bundang Hospital, 82 Gumi-ro, 173beon-gil, Bundang-gu, Seongnam 463-707, Korea, Tel: 82-31-787-7541, Fax: 82-31-787-4068, E-mail: <email>kyk0505@snubh.org</email>
</corresp>
</author-notes>
<pub-date pub-type="epub"><day>30</day>
<month>3</month>
<year>2014</year>
</pub-date>
<pub-date pub-type="ppub"><month>3</month>
<year>2014</year>
</pub-date>
<volume>36</volume>
<issue>2</issue>
<fpage>57</fpage>
<lpage>61</lpage>
<history><date date-type="received"><day>27</day>
<month>11</month>
<year>2013</year>
</date>
<date date-type="rev-recd"><day>27</day>
<month>12</month>
<year>2013</year>
</date>
<date date-type="accepted"><day>25</day>
<month>2</month>
<year>2014</year>
</date>
</history>
<permissions><copyright-statement>Copyright © 2014 by The Korean Association of Maxillofacial Plastic and Reconstructive Surgeons. All rights reserved.</copyright-statement>
<copyright-year>2014</copyright-year>
<license><license-p>This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by-nc/3.0">http://creativecommons.org/licenses/by-nc/3.0</ext-link>
) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p>
</license>
</permissions>
<abstract><p>Bisphosphonate is used widely for osteoporosis treatment, but a rising concern is the risk of osteonecrosis after long-term bisphosphonate use. Such cases are increasing, suggesting a need for research to prevent and treat bisphosphonate-related osteonecrosis of jaws. A 63-year-old female took bisphosphonate (Fosamax<sup>®</sup>
) for four years for treatment of osteoporosis and stopped medication two months ago because of unhealed wound. She was treated with marginal mandibulectomy maintaining the inferior border, and a metal plate was placed to prevent mandible fracture. Four months after the mandibulectomy, mandible reconstruction surgery using iliac bone and allograft was done. Six months after reconstruction, implant placement and treatment with an overdenture was done without complications. This study presents a case with a successful result.</p>
</abstract>
<kwd-group><kwd>Bisphosphonate-related osteonecrosis of jaws</kwd>
<kwd>Osteonecrosis</kwd>
<kwd>Implant</kwd>
<kwd>Overdenture</kwd>
</kwd-group>
</article-meta>
</front>
<floats-group><fig id="f1-mprs-36-057" position="float"><label>Fig. 1.</label>
<caption><p>(A) Initial panoramic view showing an extensive bisphosphonate-related osteonecrosis of jaws of #33∼45 area. The bone appears abnormal and mottled. (B) Initial axial computed tomography scan showing abnormal necrotic bone and intraosseous sequestra. (C) Initial bone scan showing increased hot spots in the mandible corresponding with the clinical and radiological situation.</p>
</caption>
<graphic xlink:href="mprs-36-057f1"></graphic>
</fig>
<fig id="f2-mprs-36-057" position="float"><label>Fig. 2.</label>
<caption><p>(A) Intraoral view showing extensive osteonecrosis on #33∼45 area. (B) Intraoral view showing reconstruction plate fixation after marginal mandibulectomy without bone graft. (C) Postoperative panoramic view showing partially resected mandible and reconstruction plate remaining inferior border.</p>
</caption>
<graphic xlink:href="mprs-36-057f2"></graphic>
</fig>
<fig id="f3-mprs-36-057" position="float"><label>Fig. 3.</label>
<caption><p>(A) Four months after mandibular resection, three pieces of iliac block bone were adapted on the defect site and fixated with miniplate. Allogenous bone (DBX putty) was covered between block bones and miniplate. (B) Postoperative panoramic view showing adapted iliac bone and miniplate fixation.</p>
</caption>
<graphic xlink:href="mprs-36-057f3"></graphic>
</fig>
<fig id="f4-mprs-36-057" position="float"><label>Fig. 4.</label>
<caption><p>(A) Six months after bone graft, implant first surgery was performed on #33 and 43 area. (B) Panoramic view after implant placement showing two implants and well maintaining grafted bone.</p>
</caption>
<graphic xlink:href="mprs-36-057f4"></graphic>
</fig>
<fig id="f5-mprs-36-057" position="float"><label>Fig. 5.</label>
<caption><p>(A) Four months after implant placement, second surgery was performed and locators were placed. (B) Intraoral view showing complete denture on maxilla and overdenture on mandible. They have functioned successfully without any complications for 23 months.</p>
</caption>
<graphic xlink:href="mprs-36-057f5"></graphic>
</fig>
</floats-group>
</pmc>
</record>
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