title: Bisphosphonate related osteonecrosis of the jaw--manifestation in a microvascular iliac bone flap.
abstract: Bisphosphonate related osteonecrosis of the jaw (BRONJ) is a side effect that may emerge due to a long-term bisphosphonate therapy. Although the timely diagnosis and initiation of treatment are associated with good outcome results, extended cases require whole parts of the jaw to be resected. A possible treatment option is the bony reconstruction of the jaw using microvascular bone flaps. We report, for the first time, the development of a bisphosphonate related osteonecrosis in a microvascular iliac bone graft, a reconstruction that was performed following a partial mandibulectomy due to BRONJ stage III. The observation of BRONJ manifestation in an osseous microvascular transplant is a novel finding that sheds new light on current pathogenesis theories that surround this entity. Furthermore, it is hypothesized that BRONJ is able to progress to adjacent bone. In addition, bone reconstruction in patients suffering from BRONJ may be seen more critically.
authors.affiliation: Department of Oral and Maxillofacial Surgery, University of Munich, Lindwurmstr. 2a, D-80337 Munich, Germany. christoph.pautke@gmx.net
authors.forename: Christoph
authors.initials: C
authors.lastname: Pautke
authors.forename: Sven
authors.initials: S
authors.lastname: Otto
authors.forename: Simone
authors.initials: S
authors.lastname: Reu
authors.forename: Andreas
authors.initials: A
authors.lastname: Kolk
authors.forename: Michael
authors.initials: M
authors.lastname: Ehrenfeld
authors.forename: Stephen
authors.initials: S
authors.lastname: Stürzenbaum
authors.forename: Klaus-Dietrich
authors.initials: KD
authors.lastname: Wolff
mesh_terms: D000368:Aged; D050071:Bone Density Conservation Agents / Q000009:adverse effects*; D001859:Bone Neoplasms / Q000556:secondary / Q000601:surgery; D004164:Diphosphonates / Q000009:adverse effects*; D006801:Humans; D007085:Ilium / Q000637:transplantation*; D007571:Jaw Diseases / Q000139:chemically induced* / Q000601:surgery; D008297:Male; D010020:Osteonecrosis / Q000139:chemically induced* / Q000601:surgery; D011471:Prostatic Neoplasms / Q000473:pathology / Q000601:surgery
chemical_list: D050071:Bone Density Conservation Agents; D004164:Diphosphonates