THE USE OF BUCCAL FAT PAD IN THE SURGICAL TREATMENT OF MEDICATIONRELATED OSTEONECROSIS OF MANDIBLE

Background: Treatment of the medication related osteonecrosis of the jaws is challenging. For the treatment of the stage 1 and non-advanced stage 2 cases marginal resection is used. Despite there are many studies on MRONJ treatment, high rate of disease recurrence is found (up to 47%), when intraoral wound is closed only with mucoperiosteal flaps. Aim: The aim of this study is to evaluate the usefulness of the BFP use in the surgical treatment of stage 1 and nonadvanced stage 2 mandible MRONJ, when the osteonecrosis zone is localized distal to the first molar. Method and materials: A retrospective study of 9 patients with non-advanced stage-2 MRONJ of the distal mandible was performed. In all cases, surgery included removal of the necrotic bone and tension-free closure of the formed mandibular bone wound with local mucoperiosteal flaps and BFP. Data were expressed as means ± SEM. Statistical analysis was conducted IBM SPSS Statistics 20 was used for statistical analysis. Results: In all patients, the postoperative period was uneventful. After suture removal (after 10-14 days), small areas (about 3-5 mm in diameter) of buccal fad pad exposure were found in 5 patients, which epithelialized successfully over the following month. The postoperative follow-up period was 12–16 months, during which all patients were free of symptoms: no signs of recurrence were found. Conclusion: Within the limitations of the study, the radical debridement of necrotic bone and the transposition of buccal fat pad can be used as an effective and predictable method for the treatment of distal mandible MROMJ.