title: Osteoradionecrosis of the Posterior Maxilla: A New Approach Combining Erbium: Yttrium Aluminium Garnet Laser and Bichat Bulla Flap.
abstract: Osteoradionecrosis (ORN) of the jaw is a complication of radiation therapy for head and neck cancers. We report a case of ORN of the posterior maxilla treated with Er: YAG laser and a pedicled buccal fat pad (bichat bulla adipose) flap. A 69-year-old man presented complaining of pain on left maxilla. He had received high-dose radiotherapy (90 Gy) for squamous cell carcinoma of the left soft palate 2 years earlier. Clinical and radiographic examinations revealed ORN of the left maxillary molar region and maxillary sinusitis. Daily home care consisted of 0.9% saline irrigation and 0.8% H2O2 gel application. Sequestrectomy and tooth extraction were followed by debridement with Er: YAG laser and repair with a pedicled buccal fat pad flap. Complete resolution of ORN and maxillary sinusitis was established one year postsurgically. The excellent clinical outcome suggests that Er: YAG laser debridement and pedicled buccal fat pad flap are a viable option to treat ORN of the posterior maxilla.
authors.affiliation: Department of Surgery and Translational Medicine, School of Oral Surgery, University of Milan-Bicocca, Monza, Italy.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Porcaro
authors.forename: Ernesto
authors.initials: E
authors.lastname: Amosso
authors.forename: Luca
authors.initials: L
authors.lastname: Mirabelli
authors.forename: Alberto
authors.initials: A
authors.lastname: Busa
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Carini
authors.forename: Marcello
authors.initials: M
authors.lastname: Maddalone
mesh_terms: D000273:Adipose Tissue / Q000637:transplantation*; D000368:Aged; D064592:Autografts / Q000637:transplantation; D002294:Carcinoma, Squamous Cell / Q000532:radiotherapy; D003646:Debridement / Q000379:methods; D005500:Follow-Up Studies; D006801:Humans; D006861:Hydrogen Peroxide / Q000627:therapeutic use; D053844:Lasers, Solid-State / Q000627:therapeutic use*; D008297:Male; D008439:Maxillary Diseases / Q000188:drug therapy / Q000601:surgery*; D015523:Maxillary Sinusitis / Q000188:drug therapy / Q000601:surgery; D010025:Osteoradionecrosis / Q000188:drug therapy / Q000601:surgery*; D010157:Palatal Neoplasms / Q000532:radiotherapy; D013524:Surgical Flaps / Q000637:transplantation*; D007507:Therapeutic Irrigation / Q000379:methods; D014081:Tooth Extraction / Q000379:methods; D016896:Treatment Outcome
chemical_list: D006861:Hydrogen Peroxide