Browse > Article
http://dx.doi.org/10.5125/jkaoms.2021.47.6.465

Spontaneous bone regeneration in resected non-continuous mandible due to medication-related osteonecrosis of the jaw  

Esen, Alparslan (Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Necmettin Erbakan University)
Gurses, Gokhan (Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Selcuk University)
Akkulah, Sebne (Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Necmettin Erbakan University)
Publication Information
Journal of the Korean Association of Oral and Maxillofacial Surgeons / v.47, no.6, 2021 , pp. 465-470 More about this Journal
Abstract
Few cases of spontaneous bone regeneration after extensive resection of the jaw bone have been reported, but it is more common in young adults or children. In this case, we report spontaneous bone healing in a 73-year-old female patient. On radiological examination, necrotic regions were seen in the right mandible. She was diagnosed with medication-related osteonecrosis of the jaw due to previous bisphosphonate use. After segmental resection, stabilization achieved using a reconstruction plate. The periosteum was preserved during the procedure. Twelve months later, panoramic radiography was taken and bone formation was seen both horizontally and vertically around the plate. If the periosteum is preserved and stabilization is achieved after resection in benign lesions, the bone may regenerate spontaneously regardless of age. Therefore, instead of simultaneous autogenous bone application, such patients may be followed to determine whether spontaneous bone healing will occur. This should improve patient comfort and reduce surgical cost.
Keywords
Osteonecrosis; Bone regeneration; Periosteum; Mandible;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Einhorn TA. The cell and molecular biology of fracture healing. Clin Orthop Relat Res 1998;(355 Suppl):S7-21. https://doi.org/10.1097/00003086-199810001-00003   DOI
2 Ruggiero SL, Dodson TB, Fantasia J, Goodday R, Aghaloo T, Mehrotra B, et al.; American Association of Oral and Maxillofacial Surgeons. American Association of Oral and Maxillofacial Surgeons position paper on medication-related osteonecrosis of the jaw--2014 update. J Oral Maxillofac Surg 2014;72:1938-56. https://doi.org/10.1016/j.joms.2014.04.031   DOI
3 Reid IR, Bolland MJ, Grey AB. Is bisphosphonate-associated osteonecrosis of the jaw caused by soft tissue toxicity? Bone 2007;41:318-20. https://doi.org/10.1016/j.bone.2007.04.196   DOI
4 Kazanjian VH. Spontaneous regeneration of bone following excision of section of the mandible. Am J Orthod Oral Surg 1946;32:242-8. https://doi.org/10.1016/0096-6347(46)90016-6   DOI
5 Kisner WH. Spontaneous posttraumatic mandibular regeneration. Plast Reconstr Surg 1980;66:442-7.   DOI
6 Anyanechi CE, Saheeb BD, Bassey GO. Spontaneous bone regeneration after segmental mandibular resection: a retrospective study of 13 cases. Int J Oral Maxillofac Surg 2016;45:1268-72. https://doi.org/10.1016/j.ijom.2016.04.011   DOI
7 de Villa GH, Chen CT, Chen YR. Spontaneous bone regeneration of the mandible in an elderly patient: a case report and review of the literature. Chang Gung Med J 2003;26:363-9.
8 Elbeshir EI. Spontaneous regeneration of the mandibular bone following hemimandibulectomy. Br J Oral Maxillofac Surg 1990;28:128-30. https://doi.org/10.1016/0266-4356(90)90140-g   DOI
9 Okoturo E, Ogunbanjo OV, Arotiba GT. Spontaneous regeneration of the mandible: an institutional audit of regenerated bone and osteocompetent periosteum. J Oral Maxillofac Surg 2016;74:1660-7. https://doi.org/10.1016/j.joms.2016.02.007   DOI
10 Marx RE, Tursun R. Suppurative osteomyelitis, bisphosphonate induced osteonecrosis, osteoradionecrosis: a blinded histopathologic comparison and its implications for the mechanism of each disease. Int J Oral Maxillofac Surg 2012;41:283-9. https://doi.org/10.1016/j.ijom.2011.12.016   DOI
11 McKibbin B. The biology of fracture healing in long bones. J Bone Joint Surg Br 1978;60-B:150-62. https://doi.org/10.1302/0301-620X.60B2.350882   DOI
12 Boyne PJ. The restoration of resected mandibles in children without the use of bone grafts. Head Neck Surg 1983;6:626-31. https://doi.org/10.1002/hed.2890060203   DOI
13 Shuker S. Spontaneous regeneration of the mandible in a child. A sequel to partial avulsion as a result of a war injury. J Maxillofac Surg 1985;13:70-3. https://doi.org/10.1016/s0301-0503(85)80019-9   DOI
14 Ruggiero SL, Donoff RB. Bone regeneration after mandibular resection: report of two cases. J Oral Maxillofac Surg 1991;49:647-52. https://doi.org/10.1016/0278-2391(91)90349-q   DOI
15 Li Z, Pan J, Ma J, Zhang Z, Bai Y. Microarray gene expression of periosteum in spontaneous bone regeneration of mandibular segmental defects. Sci Rep 2017;7:13535. https://doi.org/10.1038/s41598-017-13586-8   DOI
16 Duchamp de Lageneste O, Julien A, Abou-Khalil R, Frangi G, Carvalho C, Cagnard N, et al. Periosteum contains skeletal stem cells with high bone regenerative potential controlled by Periostin. Nat Commun 2018;9:773. https://doi.org/10.1038/s41467-018-03124-z   DOI
17 Qaisi M, Montague L. Bone margin analysis for osteonecrosis and osteomyelitis of the jaws. Oral Maxillofac Surg Clin North Am 2017;29:301-13. https://doi.org/10.1016/j.coms.2017.03.007   DOI
18 Goh BT, Lee S, Tideman H, Stoelinga PJ. Mandibular reconstruction in adults: a review. Int J Oral Maxillofac Surg 2008;37:597-605. https://doi.org/10.1016/j.ijom.2008.03.002   DOI
19 Zhang Z, Hu J, Ma J, Pan J. Spontaneous regeneration of bone after removal of a vascularised fibular bone graft from a mandibular segmental defect: a case report. Br J Oral Maxillofac Surg 2015;53:650-1. https://doi.org/10.1016/j.bjoms.2015.04.002   DOI
20 Abdulai AE. Complete spontaneous bone regeneration following partial mandibulectomy. Ghana Med J 2012;46:174-7.