Evaluation of segmental mandibular resection without microvascular reconstruction in patients affected by medication-related osteonecrosis of the jaw: a systematic review
| Autor: | G. Umar, Oladapo Akintola, Raphael Capelli Guerra, Roberto Sacco |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
MEDLINE Angiogenesis Inhibitors 03 medical and health sciences 0302 clinical medicine Neoplasms Medicine Humans In patient Bone Density Conservation Agents Diphosphonates business.industry Osteonecrosis Postoperative complication 030206 dentistry medicine.disease Mandibular resection Surgery Denosumab Otorhinolaryngology 030220 oncology & carcinogenesis Cohort Bisphosphonate-Associated Osteonecrosis of the Jaw Oral Surgery Segmental resection business Osteonecrosis of the jaw medicine.drug |
| Zdroj: | The British journal of oralmaxillofacial surgery. 59(6) |
| ISSN: | 1532-1940 |
| Popis: | Medication-related osteonecrosis of the jaw (MRONJ) is a severe condition that affects the jaw in patients exposed to specific drugs. More often it has been described in association with bisphosphonates (BP), but nowadays it has been observed with the use of other medications, such as denosumab (a RANK ligand inhibitor and monoclonal antibody agent) and antiangiogenic drugs. Managing the condition has unfortunately proven difficult and still remains a major challenge for clinicians and surgeons. The aim of this systematic review was to identify and analyse the evidence on mandibular segmental resection in patients with advanced MRONJ. A multi-database (PubMed, MEDLINE, EMBASE, CINAHL, and Cochrane Central Register of Controlled Trials) systematic search was performed. Any type of study on human patients treated with antiresorptive and antiangiogenic drugs was considered. The primary aim was to understand the success of mandibular segmental resection in the short, medium, and long term, and to understand its effects before, during, and after the operation. The search yielded 11 studies that were eligible for analysis with a total of 67 patients. Of the 11 studies, seven reported no complications, and overall, postoperative complications were seen in 16 cases. Recurrence of osteonecrosis was reported in one study. The most common postoperative complication was removal of hardware (n = 11). The mean (SD) follow-up time for eight studies was 35.57 (17.73) months. According to the limited data available in the literature, mandibular segmental resection is a viable treatment that has been used successfully in patients with various stages of MRONJ. The data show a relatively high percentage of recurrence. Additional data based on a larger cohort of patients or case-control studies are necessary to justify routine use of this type of intervention in patients affected by the condition. |
| Databáze: | OpenAIRE |
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