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22.04.2018 | Original Article

Comparison of mucosal and mucoperiosteal wound cover for the treatment of medication-related osteonecrosis of the jaw lesions: a retrospective cohort study

verfasst von: Nicola Nonnenmühlen, A. Burnic, A. Bartella, B. Lethaus, F. Gerhards, O. Ristow, C. Pautke, F. Hölzle, T. Steiner

Erschienen in: Clinical Oral Investigations | Ausgabe 1/2019

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Abstract

Objectives

Actually, there is no detailed guidance on how to deal with wound closure after surgical removal of medication-related osteonecrosis of the jaw (MRONJ) lesions. This study attempts to compare the difference in outcome between the mucosal and the mucoperiosteal flap closure after surgery.

Patients and methods

In this retrospective monocentric cohort study, patients (n = 61; 35 female/26 male) suffering from MRONJ and requiring surgical therapy at the University of Aachen between 2013 and 2015 were included. Due to intra-institutional variances, one group was treated with the mucosal, the other group with the mucoperiosteal technique. The success rate, i.e., mucosal closure and no relapse at the point of follow-up, was evaluated and compared. All patients were clinically investigated for the postoperative follow-up during a special consultation appointment.

Results

The success rates between the different techniques after 2 years follow-up were very similar. In the group of mucosal wound closure, 22 of 29 (75.86%) patients revealed mucosal integrity without signs of MRONJ. The rate in the mucoperiosteal wound closure group was almost identical (24 of 32 (75%)).

Conclusion

No differences in the success rates between the two different techniques could be evaluated.

Clinical relevance

The results of this study suggest that the complete removal of the necrotic bone might have a higher impact on the success rates than the technique of the wound closure. Due to the fact that the mucoperiosteal wound closure technique offers a better overview of the extent of the MRONJ lesion, the authors advise to use this technique.

Berenson JR, Lichtenstein A, Porter L, Dimopoulos MA, Bordoni R, George S, Lipton A, Keller A, Ballester O, Kovacs MJ, Blacklock HA, Bell R, Simeone J, Reitsma DJ, Heffernan M, Seaman J, Knight RD (1996) Efficacy of pamidronate in reducing skeletal events in patients with advanced multiple myeloma. Myeloma Aredia Study Group. N Engl J Med 334(8):488–493. https://doi.org/10.1056/nejm199602223340802 CrossRefPubMed

Black DM, Cummings SR, Karpf DB, Cauley JA, Thompson DE, Nevitt MC, Bauer DC, Genant HK, Haskell WL, Marcus R, Ott SM, Torner JC, Quandt SA, Reiss TF, Ensrud KE (1996) Randomised trial of effect of alendronate on risk of fracture in women with existing vertebral fractures. Fracture Intervention Trial Research Group. Lancet 348(9041):1535–1541CrossRefPubMed

Park JB, Cho SH, Kim I, Lee W, Kang SH, Kim H (2017) Evaluation of the bisphosphonate effect on stem cells derived from jaw bone and long bone rabbit models: a pilot study. Arch Oral Biol 85:178–182. https://doi.org/10.1016/j.archoralbio.2017.10.024 CrossRefPubMed

Ristow O, Gerngross C, Schwaiger M, Hohlweg-Majert B, Kehl V, Jansen H, Hahnefeld L, Otto S, Pautke C (2014) Is bone turnover of jawbone and its possible over suppression by bisphosphonates of etiologic importance in pathogenesis of bisphosphonate-related osteonecrosis? J Oral Maxillof Surg Off J Am Assoc Oral Maxillof Surg 72(5):903–910. https://doi.org/10.1016/j.joms.2013.11.005 CrossRef

Yoshimura H, Ohba S, Yoshida H, Saito K, Inui K, Yasui R, Ichikawa D, Aiki M, Kobayashi J, Matsuda S, Imamura Y, Sano K (2017) Denosumab-related osteonecrosis of the jaw in a patient with bone metastases of prostate cancer: a case report and literature review. Oncol Lett 14(1):127–136. https://doi.org/10.3892/ol.2017.6121 CrossRefPubMedPubMedCentral

Egloff-Juras C, Gallois A, Salleron J, Massard V, Dolivet G, Guillet J, Phulpin B (2017) Denosumab-related osteonecrosis of the jaw: a retrospective study. J Oral Pathol Med Off Publ Int Assoc Oral Pathol Am Acad Oral Pathol. https://doi.org/10.1111/jop.12646

American Association of Oral and Maxillofacial Surgeons position paper on bisphosphonate-related osteonecrosis of the jaws (2007). J Oral Maxillof Surg Off J Am Assoc Oral Maxillof Surg 65(3):369–376. https://doi.org/10.1016/j.joms.2006.11.003

Holzinger D, Seemann R, Klug C, Ewers R, Millesi G, Baumann A, Wutzl A (2013) Long-term success of surgery in bisphosphonate-related osteonecrosis of the jaws (BRONJs). Oral Oncol 49(1):66–70. https://doi.org/10.1016/j.oraloncology.2012.07.008 CrossRefPubMed

Otto S, Schreyer C, Hafner S, Mast G, Ehrenfeld M, Sturzenbaum S, Pautke C (2012) Bisphosphonate-related osteonecrosis of the jaws—characteristics, risk factors, clinical features, localization and impact on oncological treatment. J Cranio-maxillo-facial Surg Off Publ Eur Assoc Cranio-Maxillo-Facial Surg 40(4):303–309. https://doi.org/10.1016/j.jcms.2011.05.003 CrossRef

10.

Wutzl A, Pohl S, Sulzbacher I, Seemann R, Lauer G, Ewers R, Drach J, Klug C (2012) Factors influencing surgical treatment of bisphosphonate-related osteonecrosis of the jaws. Head Neck 34(2):194–200. https://doi.org/10.1002/hed.21708 CrossRefPubMed

11.

Carlson ER, Basile JD (2009) The role of surgical resection in the management of bisphosphonate-related osteonecrosis of the jaws. J Oral Maxillof Surg Off J Am Assoc Oral Maxillofac Surg 67(5 Suppl):85–95. https://doi.org/10.1016/j.joms.2009.01.006 CrossRef

12.

Ristow O, Otto S, Troeltzsch M, Hohlweg-Majert B, Pautke C (2015) Treatment perspectives for medication-related osteonecrosis of the jaw (MRONJ). J Cranio-maxillo-facial Surg Off Publ Eur Assoc Cranio-Maxillo-Facial Surg 43(2):290–293. https://doi.org/10.1016/j.jcms.2014.11.014 CrossRef

13.

Lopes RN, Rabelo GD, Rocha AC, Carvalho PA, Alves FA (2015) Surgical therapy for bisphosphonate-related osteonecrosis of the jaw: six-year experience of a single institution. J Oral Maxillof Surg Off J Am Assoc Oral Maxillof Surg 73(7):1288–1295. https://doi.org/10.1016/j.joms.2015.01.008 CrossRef

14.

Bedogni A, Saia G, Bettini G, Tronchet A, Totola A, Bedogni G, Ferronato G, Nocini PF, Blandamura S (2011) Long-term outcomes of surgical resection of the jaws in cancer patients with bisphosphonate-related osteonecrosis. Oral Oncol 47(5):420–424. https://doi.org/10.1016/j.oraloncology.2011.02.024 CrossRefPubMed

15.

K.A.Grötz J-UP Al Nawas (2012) Bisphosphonat-assoziierte Kiefernekrose (BP-ONJ) und andere Medikamenten-assoziierte Kiefernekrosen.18

16.

AAOMS (2007) American Association of Oral and Maxillofacial Surgeons position paper on bisphosphonate-related osteonecrosis of the jaws. J Oral Maxillofac Surg 65(3):369–376. https://doi.org/10.1016/j.joms.2006.11.003 CrossRef

17.

Stockmann P, Vairaktaris E, Wehrhan F, Seiss M, Schwarz S, Spriewald B, Neukam FW, Nkenke E (2010) Osteotomy and primary wound closure in bisphosphonate-associated osteonecrosis of the jaw: a prospective clinical study with 12 months follow-up. Supp Care Cancer Off J Multinatl Assoc Supp Care Cancer 18(4):449–460. https://doi.org/10.1007/s00520-009-0688-1 CrossRef

18.

Wilde F, Heufelder M, Winter K, Hendricks J, Frerich B, Schramm A, Hemprich A (2011) The role of surgical therapy in the management of intravenous bisphosphonates-related osteonecrosis of the jaw. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 111(2):153–163. https://doi.org/10.1016/j.tripleo.2010.04.015 CrossRefPubMed

19.

Graziani F, Vescovi P, Campisi G, Favia G, Gabriele M, Gaeta GM, Gennai S, Goia F, Miccoli M, Peluso F, Scoletta M, Solazzo L, Colella G (2012) Resective surgical approach shows a high performance in the management of advanced cases of bisphosphonate-related osteonecrosis of the jaws: a retrospective survey of 347 cases. J Oral Maxillof Surg Off J Am Assoc Oral Maxillof Surg 70(11):2501–2507. https://doi.org/10.1016/j.joms.2012.05.019 CrossRef

20.

Ruggiero SL, Dodson TB, Assael LA, Landesberg R, Marx RE, Mehrotra B (2009) American Association of Oral and Maxillofacial Surgeons position paper on bisphosphonate-related osteonecrosis of the jaw—2009 update. Aust Endod J, J Aust Soc Endod Inc 35(3):119–130. https://doi.org/10.1111/j.1747-4477.2009.00213.x CrossRef

21.

Ruggiero SL, Dodson TB, Fantasia J, Goodday R, Aghaloo T, Mehrotra B, O'Ryan F (2014) American Association of Oral and Maxillofacial Surgeons position paper on medication-related osteonecrosis of the jaw—2014 update. J Maxillof Surg Off J Am Assoc Oral Maxillof Surg 72(10):1938–1956. https://doi.org/10.1016/j.joms.2014.04.031 CrossRef

22.

Joda TGP, Ehmke B (2008) Arbeitshandbuch Parodontologie Band 2 Chirurgische Therapie. Books on Demand GmbH, Norderstedt, pp 11–99

23.

Marx RE, Sawatari Y, Fortin M, Broumand V (2005) Bisphosphonate-induced exposed bone (osteonecrosis/osteopetrosis) of the jaws: risk factors, recognition, prevention, and treatment. J Oral Maxillofac Surg Off J Am Assoc Oral Maxillofac Surg 63(11):1567–1575. https://doi.org/10.1016/j.joms.2005.07.010 CrossRef

24.

Ruggiero SL, Mehrotra B, Rosenberg TJ, Engroff SL (2004) Osteonecrosis of the jaws associated with the use of bisphosphonates: a review of 63 cases. J Oral Maxillofac Surg Off J Am Assoc Oral Maxillofac Surg 62(5):527–534CrossRef

25.

Magopoulos C, Karakinaris G, Telioudis Z, Vahtsevanos K, Dimitrakopoulos I, Antoniadis K, Delaroudis S (2007) Osteonecrosis of the jaws due to bisphosphonate use. A review of 60 cases and treatment proposals. Am J Otolaryngol 28(3):158–163. https://doi.org/10.1016/j.amjoto.2006.08.004 CrossRefPubMed

26.

Voss PJ, Joshi Oshero J, Kovalova-Muller A, Veigel Merino EA, Sauerbier S, Al-Jamali J, Lemound J, Metzger MC, Schmelzeisen R (2012) Surgical treatment of bisphosphonate-associated osteonecrosis of the jaw: technical report and follow up of 21 patients. J Cranio-Maxillo-Facial Surg Off Publ Eur Assoc Cranio-Maxillo-Facial Surg 40(8):719–725. https://doi.org/10.1016/j.jcms.2012.01.005 CrossRef

27.

Hoefert S, Eufinger H (2011) Relevance of a prolonged preoperative antibiotic regime in the treatment of bisphosphonate-related osteonecrosis of the jaw. J Oral Maxillofac Surg Off J Am Assoc Oral Maxillofac Surg 69(2):362–380. https://doi.org/10.1016/j.joms.2010.06.200 CrossRef

28.

Schubert M, Klatte I, Linek W, Muller B, Doring K, Eckelt U, Hemprich A, Berger U, Hendricks J (2012) The saxon bisphosphonate register—therapy and prevention of bisphosphonate-related osteonecrosis of the jaws. Oral Oncol 48(4):349–354. https://doi.org/10.1016/j.oraloncology.2011.11.004 CrossRefPubMed

29.

Hoff AO, Toth BB, Altundag K, Johnson MM, Warneke CL, Hu M, Nooka A, Sayegh G, Guarneri V, Desrouleaux K, Cui J, Adamus A, Gagel RF, Hortobagyi GN (2008) Frequency and risk factors associated with osteonecrosis of the jaw in cancer patients treated with intravenous bisphosphonates. J Bone Miner Res Off J Am Soc Bone Miner Res 23(6):826–836. https://doi.org/10.1359/jbmr.080205 CrossRef

30.

Sven Otto M, DMD, FEBOMFS (2015) Medication-related osteonecrosis of the jaws Bisphosphonates, Denosumab and New Agents. Springer-Verlag Berlin, Heidelberg, pp 1–217

31.

Rupel K, Ottaviani G, Gobbo M, Contardo L, Tirelli G, Vescovi P, Di Lenarda R, Biasotto M (2014) A systematic review of therapeutical approaches in bisphosphonates-related osteonecrosis of the jaw (BRONJ). Oral Oncol 50(11):1049–1057. https://doi.org/10.1016/j.oraloncology.2014.08.016 CrossRefPubMed

32.

yKim HY, Lee SJ, Kim SM, Myoung H, Hwang SJ, Choi JY, Lee JH, Choung PH, Kim MJ, Seo BM (2017) Extensive surgical procedures result in better treatment outcomes for bisphosphonate-related osteonecrosis of the jaw in patients with osteoporosis. J Oral Maxillofac Surg Off J Am Assoc Oral Maxillofac Surg 75(7):1404–1413. https://doi.org/10.1016/j.joms.2016.12.014 CrossRef

33.

Fliefel R, Troltzsch M, Kuhnisch J, Ehrenfeld M, Otto S (2015) Treatment strategies and outcomes of bisphosphonate-related osteonecrosis of the jaw (BRONJ) with characterization of patients: a systematic review. Int J Oral Maxillofac Surg 44(5):568–585. https://doi.org/10.1016/j.ijom.2015.01.026 CrossRefPubMed

34.

Comas-Calonge A, Figueiredo R, Gay-Escoda C (2017) Surgical treatment vs. conservative treatment in intravenous bisphosphonate-related osteonecrosis of the jaws. Systematic review. J Clin Exp Dent 9(2):e302–e307. https://doi.org/10.4317/jced.53504 CrossRefPubMedPubMedCentral

35.

Mucke T, Koschinski J, Deppe H, Wagenpfeil S, Pautke C, Mitchell DA, Wolff KD, Holzle F (2011) Outcome of treatment and parameters influencing recurrence in patients with bisphosphonate-related osteonecrosis of the jaws. J Cancer Res Clin Oncol 137(5):907–913. https://doi.org/10.1007/s00432-010-0953-1 CrossRefPubMed

36.

Wutzl A, Eisenmenger G, Hoffmann M, Czerny C, Moser D, Pietschmann P, Ewers R, Baumann A (2006) Osteonecrosis of the jaws and bisphosphonate treatment in cancer patients. Wien Klin Wochenschr 118(15–16):473–478. https://doi.org/10.1007/s00508-006-0644-8 CrossRefPubMed

37.

Ruggiero SL, Dodson TB, Assael LA, Landesberg R, Marx RE, Mehrotra B (2009) American Association of Oral and Maxillofacial Surgeons position paper on bisphosphonate-related osteonecrosis of the jaws—2009 update. J Oral Maxillofac Surg Off J Am Assoc Oral Maxillofac Surg 67(5 Suppl):2–12. https://doi.org/10.1016/j.joms.2009.01.009 CrossRef

38.

Marx RE (1983) Osteoradionecrosis: a new concept of its pathophysiology. J Oral Maxillofac Surg Off I Am Assoc Oral Maxillofac Surg 41(5):283–288CrossRef

39.

Pautke C, Tischer T, Neff A, Horch HH, Kolk A (2006) In vivo tetracycline labeling of bone: an intraoperative aid in the surgical therapy of osteoradionecrosis of the mandible. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 102(6):e10–e13. https://doi.org/10.1016/j.tripleo.2006.05.007 CrossRefPubMed

40.

Ristow O, Otto S, Geiss C, Kehl V, Berger M, Troeltzsch M, Koerdt S, Hohlweg-Majert B, Freudlsperger C, Pautke C (2017) Comparison of auto-fluorescence and tetracycline fluorescence for guided bone surgery of medication-related osteonecrosis of the jaw: a randomized controlled feasibility study. Int J Oral Maxillofac Surg 46(2):157–166. https://doi.org/10.1016/j.ijom.2016.10.008 CrossRefPubMed

41.

Pautke C, Bauer F, Otto S, Tischer T, Steiner T, Weitz J, Kreutzer K, Hohlweg-Majert B, Wolff KD, Hafner S, Mast G, Ehrenfeld M, Sturzenbaum SR, Kolk A (2011) Fluorescence-guided bone resection in bisphosphonate-related osteonecrosis of the jaws: first clinical results of a prospective pilot study. J Oral Maxillofac Surg Off J Am Assoc Oral Maxillofac Surg 69(1):84–91. https://doi.org/10.1016/j.joms.2010.07.014 CrossRef

42.

Otto S, Ristow O, Pache C, Troeltzsch M, Fliefel R, Ehrenfeld M, Pautke C (2016) Fluorescence-guided surgery for the treatment of medication-related osteonecrosis of the jaw: a prospective cohort study. J Cranio-Maxillo-Facial Surg Off Publ Eur Assoc Cranio-Maxillo-Facial Surg 44:1073–1080. https://doi.org/10.1016/j.jcms.2016.05.018 CrossRef

Titel: Comparison of mucosal and mucoperiosteal wound cover for the treatment of medication-related osteonecrosis of the jaw lesions: a retrospective cohort study
verfasst von: Nicola Nonnenmühlen
A. Burnic
A. Bartella
B. Lethaus
F. Gerhards
O. Ristow
C. Pautke
F. Hölzle
T. Steiner
Publikationsdatum: 22.04.2018
Verlag: Springer Berlin Heidelberg
Erschienen in: Clinical Oral Investigations / Ausgabe 1/2019
Print ISSN: 1432-6981
Elektronische ISSN: 1436-3771
DOI: https://doi.org/10.1007/s00784-018-2443-9

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Comparison of mucosal and mucoperiosteal wound cover for the treatment of medication-related osteonecrosis of the jaw lesions: a retrospective cohort study

Abstract

Objectives

Patients and methods

Results

Conclusion

Clinical relevance

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Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

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Abstract

Objectives

Patients and methods

Results

Conclusion

Clinical relevance

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