Abstract
The purpose of this study was to evaluate the clinical outcomes of patients with stage
3 mandibular medication-related osteonecrosis of the jaw (MRONJ) treated using a submental
island flap in combination with mylohyoid muscle reconstruction after rim mandibulectomy.
The medical records of 12 patients treated between January 2019 and April 2022 were
analysed retrospectively. Primary wound healing was assessed as the maintenance of
full mucosal coverage without signs of infection at 6 months postoperatively. The
follow-up period ranged from 7 to 38 months, with an average of 21.8 months. All 12
patients (100%) experienced primary wound healing, with normal mouth opening and occlusion,
and without pathological mandibular fracture or facial aesthetic problems during the
follow-up period. Postoperative panoramic images revealed new bone formation in the
treated areas of the mandible in four patients. During the follow-up period, one patient
continuing bevacizumab and zoledronate administration for the primary cancer developed
MRONJ in the same area at 13 months postoperatively and finally died. Hence the total
success rate was 91.7%. In summary, for patients with stage 3 mandibular MRONJ treated
with rim mandibulectomy, the submental island flap combined with mylohyoid muscle
is an effective reconstructive option for wound-healing and possible bone regeneration
of denuded bone.
Keywords
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Article info
Publication history
Published online: December 24, 2022
Accepted:
December 13,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2022 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.
