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'Autoreconstruction' of the Mandible-Report of a Case
Sarina E C Pichardo1, Pieter de Roos2, J P Richard van Merkesteyn3
1Department of Oral & Maxillofacial Surgery (Chair: Prof. Dr. JPR van Merkesteyn), Leiden University Medical Center, P.O. Box 9600, 2300 RC LEIDEN, The Netherlands. s.e.c.pichardo@lumc.nl.
Abstract:
Bisphosphonate-related osteonecrosis of the jaw (BRONJ) was first mentioned in the literature in 2003. Since then, several reports have been published referring to this disease. The etiology of BRONJ still remains unclear. The treatment of BRONJ also remains a topic of discussion between those who are in favor of a conservative treatment and those who are convinced that surgical treatment gives the best results. In this case report, a patient is presented with BRONJ in the mandible which has been treated surgically in combination with antibiotic treatment. During surgery it appeared that a large part of the jaw was sequestrated full-thickness with, at the same time, formation of a substantial amount of subperiosteal bone that was formed around the BRONJ, supporting the sequestrated part of the mandible and, after sequestrectomy, serving as a neo-mandible. This case shows the capacity of the jawbone despite bisphosphonate use to regenerate itself.