Application of bone perforation in the surgery of medication-related osteonecrosis of the jaw in stage Ⅱ.

Na Gao, Mei Tian, Yawei Sun, Danni Wang, Guowen Sun
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Abstract

Objectives: This study aimed to explore the effect of surgery combined with bone perforation for treating stage Ⅱ medication-related osteonecrosis of the jaw (MRONJ).

Methods: A total of 21 patients with stage Ⅱ mandibular MRONJ who underwent surgical treatment from June 2020 to June 2023 were included in this study. Retrospective analysis was conducted on their clinical data, including gender, age, primary disease, drug name and administration method, pre-surgery drug cessation, and prognosis. The cohort comprised 14 males and 7 females, with an average age at onset of 68.33±10.74 years. According to the guidelines of the American Association of Oral and Maxillofacial Surgeons, the included patients had stage Ⅱ mandibular MRONJ. The treatment approach consisted of partial mandibulectomy combined with bone perforation techniques, ensuring tension-free suturing of soft tissues. Follow-up was performed regularly, and the curative effect was evaluated. The SF-12 health survey was used to assess the quality of life for all patients before and after surgery.

Results: A total of 21 patients were followed up for 8-38 months after surgery, and the mucosal healing of 17 patients was good (80.95%). The postoperative quality of life score (83.62±5.90) was significantly higher than that before operation (63.67±4.70, P<0.05).

Conclusions: Surgery combined with bone perforation te-chnique is an effective treatment method with high success rate in refractory stage Ⅱ MRONT patients.

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骨穿孔术在Ⅱ期药物性颌骨坏死手术中的应用。
研究目的本研究旨在探讨手术联合骨穿治疗Ⅱ期药物相关性下颌骨骨坏死(MRONJ)的效果:纳入2020年6月至2023年6月期间接受手术治疗的21例Ⅱ期下颌骨MRONJ患者。对他们的临床数据进行了回顾性分析,包括性别、年龄、原发疾病、药物名称和给药方式、术前停药情况和预后。组群中有 14 名男性和 7 名女性,平均发病年龄为(68.33±10.74)岁。根据美国口腔颌面外科医生协会的指南,纳入的患者均为Ⅱ期下颌骨 MRONJ。治疗方法包括下颌骨部分切除术,结合骨穿孔技术,确保软组织无张力缝合。定期随访,评估疗效。采用 SF-12 健康调查评估所有患者手术前后的生活质量:结果:共有 21 名患者在术后接受了 8-38 个月的随访,其中 17 名患者的粘膜愈合良好(80.95%)。术后生活质量评分(83.62±5.90)明显高于术前(63.67±4.70,PC结论:对于难治性 MRONT Ⅱ期患者,手术联合骨穿技术是一种有效的治疗方法,成功率高。
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