PDF(Pubmed)
Abstract：
Surgical intervention for medication-related jaw osteonecrosis (MRONJ) is currently the main treatment method, offering a higher healing rate than conservative approaches. However, the management of bony defects after sequestrectomy remains a challenging issue due to poor vascularization from the drug effect. The use of pedicled buccal fat pad (PBFP) for filling bone defects has become common and effective but is limited to the posterior maxillary region. To add to the advantages of the buccal fat pad, we explored a novel treatment approach using a free buccal fat pad (FBFP) to fill bone defects other than the posterior maxilla. While the FBFP has been employed in oral defect reconstruction, currently published cases have been utilized in recipient sites with good blood supply. There has yet to be any usage in poor vascularization defects like MRONJ. This article describes that the FBFP was used to fill the surgical defects of 8 patients who were diagnosed with MRONJ and who underwent sequestrectomy and saucerization. During follow-up visits, there was excellent wound healing and no significant tissue depression. Based on successful treatment experiences, FBFP is a reliable therapeutic option for the management of poor vascularization defects like MRONJ treated through surgical intervention.
摘要：
手术介入治疗药物相关性颌骨坏死(MRONJ)是目前主要的治疗方法,提供比保守方法更高的治愈率。然而,由于药物作用导致的血管形成不良,因此,手术后骨缺损的处理仍然是一个具有挑战性的问题.使用带蒂颊脂肪垫（PBFP）填充骨缺损已变得普遍且有效，但仅限于上颌后部区域。为了增加颊脂肪垫的优点，我们探索了一种新的治疗方法，该方法使用游离的颊脂肪垫（FBFP）来填充上颌骨后部以外的骨缺损。虽然FBFP已用于口腔缺损重建，目前已发表的病例已在血液供应良好的受体部位使用。在像MRONJ这样的不良血管化缺陷中还没有任何用法。本文介绍了FBFP用于填补8例被诊断为MRONJ并接受了隔离切除术和碟形切除术的患者的手术缺陷。在后续访问中，伤口愈合良好，无明显组织抑制。根据成功的治疗经验，FBFP是一种可靠的治疗选择，可以治疗不良的血管形成缺陷，例如通过手术干预治疗的MRONJ。
