J Korean Assoc Oral Maxillofac Surg.  2021 Dec;47(6):465-470. 10.5125/jkaoms.2021.47.6.465.

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

• Esen A
• Gurses G
• Akkulah S

• KMID: 2524706
• DOI: http://doi.org/10.5125/jkaoms.2021.47.6.465

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.

Keyword

Osteonecrosis; Bone regeneration; Periosteum; Mandible

Figure

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  Fig. 1 An extraoral fistula originating from medication-related osteonecrosis of the jaw is seen in the submandibular region.

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  Fig. 2 The panoramic radiograph showed that about 3-cm-long lesion on the body of the mandible starting from the mental foramen and extending to the posterior region. At the same time, reactive bone formation was observed as a result of periosteal activation in the lower part of the lesion (arrows).

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  Fig. 3 The resection was performed and the reconstruction plate was fixed to the area.

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  Fig. 4 One year later, complete bone regeneration was observed on the radiograph.

Reference

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