title: Sinusitis and oroantral fistula in patients with bisphosphonate-associated necrosis of the maxilla.
abstract: BACKGROUND
  The management of bisphosphonate related necrosis of the jaw has become clinical routine. While approximately two thirds of the lesions are in the mandible, one third is located in the maxilla. In 40-50 % of maxillary necrosis the maxillary sinus is involved, leading to maxillary sinusitis and oro-antral communications.
  
  
  METHODS
  This retrospective single center study includes all patients with diagnosis of BP-ONJ of the maxilla and concomitant maxillary sinusitis. The information collected includes age, gender, primary disease, bisphosphonate intake, involving type of bisphosphonate, route of administration and duration of BP treatment previous to surgical treatment and treatment outcome.
  
  
  RESULTS
  A total of 12 patients fulfill the criteria of the diagnosis of maxillary sinusitis associated to maxillary necrosis, of which 6 Patients showed purulent sinusitis. All patients underwent surgical treatment with complete resection of the affected bone and a multilayer wound closure. A recurrence appeared in one patient with open bone and no sign of sinusitis and was treated conservatively.
  
  
  CONCLUSIONS
  Purulent maxillary Sinusitis is a common complication of bisphosphonate-related necrosis of the maxilla. The surgical technique described can be suggested for the treatment of these patients.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Regional Plastic Surgery, Medical Center - University of Freiburg , Hugstetter Str. 55, 79106, Freiburg im Breisgau, Germany. pit.voss@uniklinik-freiburg.de.
authors.forename: Pit Jacob
authors.initials: PJ
authors.lastname: Voss
authors.affiliation: Department of Oral and Maxillofacial Surgery, Hospital San Juan de Dios, Universidad Latina, San José, Costa Rica.
authors.forename: Gustavo
authors.initials: G
authors.lastname: Vargas Soto
authors.affiliation: Department of Oral and Maxillofacial Surgery, Regional Plastic Surgery, Medical Center - University of Freiburg , Hugstetter Str. 55, 79106, Freiburg im Breisgau, Germany.
authors.forename: Rainer
authors.initials: R
authors.lastname: Schmelzeisen
authors.affiliation: Department of Oral and Maxillofacial Surgery, Fukuoka Dental College, Fukuoka, Japan.
authors.forename: Kiwako
authors.initials: K
authors.lastname: Izumi
authors.affiliation: Department of Oral and Maxillofacial Surgery, Regional Plastic Surgery, Medical Center - University of Freiburg , Hugstetter Str. 55, 79106, Freiburg im Breisgau, Germany.
authors.forename: Andres
authors.initials: A
authors.lastname: Stricker
authors.affiliation: Department of Oral and Maxillofacial Surgery, Regional Plastic Surgery, Medical Center - University of Freiburg , Hugstetter Str. 55, 79106, Freiburg im Breisgau, Germany.
authors.forename: Gido
authors.initials: G
authors.lastname: Bittermann
authors.affiliation: Department of Oral and Maxillofacial Surgery, Regional Plastic Surgery, Medical Center - University of Freiburg , Hugstetter Str. 55, 79106, Freiburg im Breisgau, Germany.
authors.forename: Philipp
authors.initials: P
authors.lastname: Poxleitner
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D059266:Bisphosphonate-Associated Osteonecrosis of the Jaw / Q000150:complications / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008437:Maxilla; D008875:Middle Aged; D012189:Retrospective Studies; D012852:Sinusitis / Q000209:etiology / Q000382:microbiology / Q000601:surgery*; D013524:Surgical Flaps; D016896:Treatment Outcome