A technique for the treatment of oral-antral fistulas resulting from medication-related osteonecrosis of the maxilla: The combined buccal fat pad flap and radical sinusotomy

James C. Melville, Ramzey Tursun, Jonathan W. Shum, Simon Young, Issa A. Hanna, Robert Marx

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Objective: Bisphosphonates and monoclonal antibodies directed at osteoclastic function are frequently used to treat postmenopausal and corticosteroid-induced osteoporosis. They are also used in the treatment of certain metastatic malignancies. However, osteonecrosis of the jaw has been reported after intravenous, subcutaneous, or oral use of these agents. More than 12 million Americans and another 20 million worldwide are thought to be taking a bisphosphonate. Exposed bone with oral-antral fistulas has been known to occur increasingly as a specific presentation of what is now termed medication-related osteonecrosis of the jaws (MRONJ) with a specific International Classification of Diseases, 10th revision (ICD-10) code. Oral-antral communications caused by bisphosphonate concomitant with secondary sinusitis represent a unique treatment challenge for the oral and maxillofacial surgeon. The purpose of this article is to demonstrate a simple but effective technique to treat oral-antral communications caused by MRONJ. Study Design: With the review and approval of the University of Miami Internal Review Board, we identified 23 patients who had undergone this surgical procedure. Results: We report a 100% resolution of osteonecrosis of the jaw (ONJ) and sinusitis with repneumatization. Conclusions: The buccal fat pad and radical sinustomy can be used as an effective and predictable technique for the resolution of oral-antral fistulas caused by MRONJ.

Original languageEnglish (US)
JournalOral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
DOIs
StateAccepted/In press - Aug 1 2015

Fingerprint

Oral Fistula
Osteonecrosis
Cheek
Maxilla
Jaw
Adipose Tissue
Diphosphonates
Sinusitis
Communication
Therapeutics
International Classification of Diseases
Osteoporosis
Adrenal Cortex Hormones
Monoclonal Antibodies
Antral
Bone and Bones

ASJC Scopus subject areas

  • Surgery
  • Oral Surgery
  • Pathology and Forensic Medicine
  • Radiology Nuclear Medicine and imaging
  • Dentistry (miscellaneous)

Cite this

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title = "A technique for the treatment of oral-antral fistulas resulting from medication-related osteonecrosis of the maxilla: The combined buccal fat pad flap and radical sinusotomy",
abstract = "Objective: Bisphosphonates and monoclonal antibodies directed at osteoclastic function are frequently used to treat postmenopausal and corticosteroid-induced osteoporosis. They are also used in the treatment of certain metastatic malignancies. However, osteonecrosis of the jaw has been reported after intravenous, subcutaneous, or oral use of these agents. More than 12 million Americans and another 20 million worldwide are thought to be taking a bisphosphonate. Exposed bone with oral-antral fistulas has been known to occur increasingly as a specific presentation of what is now termed medication-related osteonecrosis of the jaws (MRONJ) with a specific International Classification of Diseases, 10th revision (ICD-10) code. Oral-antral communications caused by bisphosphonate concomitant with secondary sinusitis represent a unique treatment challenge for the oral and maxillofacial surgeon. The purpose of this article is to demonstrate a simple but effective technique to treat oral-antral communications caused by MRONJ. Study Design: With the review and approval of the University of Miami Internal Review Board, we identified 23 patients who had undergone this surgical procedure. Results: We report a 100{\%} resolution of osteonecrosis of the jaw (ONJ) and sinusitis with repneumatization. Conclusions: The buccal fat pad and radical sinustomy can be used as an effective and predictable technique for the resolution of oral-antral fistulas caused by MRONJ.",
author = "Melville, {James C.} and Ramzey Tursun and Shum, {Jonathan W.} and Simon Young and Hanna, {Issa A.} and Robert Marx",
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AU - Tursun, Ramzey

AU - Shum, Jonathan W.

AU - Young, Simon

AU - Hanna, Issa A.

AU - Marx, Robert

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N2 - Objective: Bisphosphonates and monoclonal antibodies directed at osteoclastic function are frequently used to treat postmenopausal and corticosteroid-induced osteoporosis. They are also used in the treatment of certain metastatic malignancies. However, osteonecrosis of the jaw has been reported after intravenous, subcutaneous, or oral use of these agents. More than 12 million Americans and another 20 million worldwide are thought to be taking a bisphosphonate. Exposed bone with oral-antral fistulas has been known to occur increasingly as a specific presentation of what is now termed medication-related osteonecrosis of the jaws (MRONJ) with a specific International Classification of Diseases, 10th revision (ICD-10) code. Oral-antral communications caused by bisphosphonate concomitant with secondary sinusitis represent a unique treatment challenge for the oral and maxillofacial surgeon. The purpose of this article is to demonstrate a simple but effective technique to treat oral-antral communications caused by MRONJ. Study Design: With the review and approval of the University of Miami Internal Review Board, we identified 23 patients who had undergone this surgical procedure. Results: We report a 100% resolution of osteonecrosis of the jaw (ONJ) and sinusitis with repneumatization. Conclusions: The buccal fat pad and radical sinustomy can be used as an effective and predictable technique for the resolution of oral-antral fistulas caused by MRONJ.

AB - Objective: Bisphosphonates and monoclonal antibodies directed at osteoclastic function are frequently used to treat postmenopausal and corticosteroid-induced osteoporosis. They are also used in the treatment of certain metastatic malignancies. However, osteonecrosis of the jaw has been reported after intravenous, subcutaneous, or oral use of these agents. More than 12 million Americans and another 20 million worldwide are thought to be taking a bisphosphonate. Exposed bone with oral-antral fistulas has been known to occur increasingly as a specific presentation of what is now termed medication-related osteonecrosis of the jaws (MRONJ) with a specific International Classification of Diseases, 10th revision (ICD-10) code. Oral-antral communications caused by bisphosphonate concomitant with secondary sinusitis represent a unique treatment challenge for the oral and maxillofacial surgeon. The purpose of this article is to demonstrate a simple but effective technique to treat oral-antral communications caused by MRONJ. Study Design: With the review and approval of the University of Miami Internal Review Board, we identified 23 patients who had undergone this surgical procedure. Results: We report a 100% resolution of osteonecrosis of the jaw (ONJ) and sinusitis with repneumatization. Conclusions: The buccal fat pad and radical sinustomy can be used as an effective and predictable technique for the resolution of oral-antral fistulas caused by MRONJ.

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