title: Surgical treatment of bisphosphonate-related osteonecrosis of the jaws with the use of buccal fat pad: case report.
abstract: Bisphosphonate-related osteonecrosis of the jaws (BROJ) has been described since 2003 as an adverse effect of bisphosphonate medications. These drugs act on the vasculature and bone remodeling, mainly on osteoclastic activity and can cause areas of necrotic bone exposure. Treatment for the BROJ is not yet defined, but surgical treatment is one of the forms proposed, which may cause oral deformities like sinus communication in some cases. In situations like this the buccal fat pad is an important alternative for coating nasal-oral communications, due its large blood supply, elasticity, absence of restriction by age and safety. This paper presents the case of a 58-year-old woman with BROJ in the left maxilla caused by the use of zoledronic acid for metastatic breast cancer. The extensive necrotic bone area was surgically removed resulting in oral sinus communication. A buccal fat pad was used to cover the defect. More studies should be performed regarding the treatment of BROJ but, if necessary, a buccal fat pad flap could be an alternative to solve nasal-oral communications related to BROJ.
authors.affiliation: Department of Stomatology, Universidade Paulista, São Paulo, SP, Brasil.
authors.forename: Luiz Fernando Mathias
authors.initials: LF
authors.lastname: Duarte
authors.affiliation: Department of Stomatology, Universidade Paulista, São Paulo, SP, Brasil.
authors.forename: Kleber
authors.initials: K
authors.lastname: Alonso
authors.affiliation: Department of Stomatology, Universidade Paulista, São Paulo, SP, Brasil.
authors.forename: Elaine Cristina
authors.initials: EC
authors.lastname: Basso
authors.affiliation: Department of Stomatology, Universidade Paulista, São Paulo, SP, Brasil.
authors.forename: Luciano Lauria
authors.initials: LL
authors.lastname: Dib
mesh_terms: D059266:Bisphosphonate-Associated Osteonecrosis of the Jaw / Q000601:surgery*; D050071:Bone Density Conservation Agents / Q000009:adverse effects; D004164:Diphosphonates / Q000009:adverse effects; D005260:Female; D006801:Humans; D007093:Imidazoles / Q000009:adverse effects; D008875:Middle Aged; D013524:Surgical Flaps; D000077211:Zoledronic Acid
chemical_list: D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D007093:Imidazoles; D000077211:Zoledronic Acid