CHSJ

Curr Health Sci J, vol. 47, no. 1, 2021

Mandibulectomy Reconstruction with Pectoralis Major Island Flap Associated with Primary Reconstruction Plate for Mandibular Medication-Related Osteonecrosis

[Case Report]

G.A. Ciobanu(1), M.I. Gheorghia(2), O.M. Petrescu(2), S.M. Popescu(3), I.E. Staicu(4)


(1)Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, Romania,
(2)Department of Oral and Maxillo-Facial Surgery, Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, Romania,
(3)Department of Oral Rehabilitation and Medical and Surgical Emergencies, Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, Romania,
(4)Department of Orthodontics, Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, Romania


Abstract:

A bimaxillary edentulous male patient, aged 67 years, diagnosed with prostate cancer who underwent intravenous bisphosphonates treatment (zoledronic acid) for about one year presented with pain in the anterior mandibular arch, with exposed necrotic bone, and was diagnosed with stage 2 medication-related osteonecrosis of the jaw (MRONJ). MRONJ is the development of bone necrosis in the oral cavity as an adverse reaction in patients treated with antiresorptive and antiangiogenic medication, without radiation therapy to the head and neck. This persistent bone necrosis does not always respond to standard treatments. The reconstruction technique with pectoralis major flap, at a distance, associated with the primary reconstruction plate, was an effective treatment modality for the treatment of large osteonecrosis noncompliant with conservatory treatments. Through this technique, the morpho-functionality of the jaw can be restored almost completely.


Keywords: Medication-related osteonecrosis of the jaw (MRONJ), zoledronic acid, mandibulectomy reconstruction, remote pectoralis major flap



Corresponding: Gheorghia Mircea Ionu, Department of Oral and Maxillo-Facial Surgery, Faculty of Dental Medicine, University of Medicine and Pharmacy, Craiova, Romania, e-mail: gheorghitamircea@yahoo.com, Sanda Mihaela Popescu, Department of Oral Rehabilitation and Medical and Surgical Emergencies, Faculty of Dental Medicine, University of Medicine and Pharmacy, Craiova, Romania, e-mail: sanda.popescu@umfcv.ro


DOI 10.12865/CHSJ.47.01.19 - Download PDF
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