Autofluorescence-guided surgery for the treatment of medication-related osteonecrosis of the jaw (MRONJ): a retrospective single-center study

Medication-related osteonecrosis of the jaw (MRONJ) has become a serious concern for patients under antiresorptive treatment, especially in the oncological setting. Different approaches have been described in the management of MRONJ, including innovative autofluorescence-guided surgery. However, unt...

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Published in:Oral surgery, oral medicine, oral pathology and oral radiology oral medicine, oral pathology and oral radiology, 2021-05, Vol.131 (5), p.519-526
Main Authors: Otto, Sven, Schnödt, Eva Maria, Haidari, Selgai, Brunner, Teresa Franziska, Aljohani, Suad, Mosleh, Mohamed, Ristow, Oliver, Troeltzsch, Matthias, Pautke, Christoph, Ehrenfeld, Michael, Fliefel, Riham
Format: Article
Language:English
Subjects:
Bisphosphonate-Associated Osteonecrosis of the Jaw - diagnostic imaging
Bisphosphonate-Associated Osteonecrosis of the Jaw - surgery
Bone Density Conservation Agents - adverse effects
Humans
Retrospective Studies
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Summary:Medication-related osteonecrosis of the jaw (MRONJ) has become a serious concern for patients under antiresorptive treatment, especially in the oncological setting. Different approaches have been described in the management of MRONJ, including innovative autofluorescence-guided surgery. However, until now, there has been a lack of data regarding the outcome. In this study, we evaluated the efficacy of minimally invasive autofluorescence-guided resection in MRONJ. Seventy-five patients with 82 lesions were included in this retrospective, single-center study. All included patients were diagnosed with MRONJ according to the American Association of Oral and Maxillofacial Surgeons guidelines and underwent autofluorescence-guided surgery with a minimum follow-up of 3 months. The primary outcome was complete integrity of the mucosa and absence of bone exposure. The MRONJ stages were stage 0 (3.7%), stage 1 (3.7%), stage 2 (75.6%), and stage 3 (17%). Overall, complete mucosal healing of all lesions after the first surgery was 81.7% (67 of 82), whereas it was 90.2% (74 of 82) after revision surgery. The study showed that autofluorescence-guided surgery is a safe and successful treatment option that can be considered for all stages of MRONJ.
ISSN:2212-4403
2212-4411
DOI:10.1016/j.oooo.2020.10.018