title: The role of mylohyoid flap in the treatment of bisphosphonate-related osteonecrosis of the jaws.
abstract: BACKGROUND
  Surgical treatment of bisphosphonate-related osteonecrosis of the jaws (BRONJ) combines excision of adequate damaged bone and watertight coverage by appropriate vascularized tissue. Local tissues are preferred when possible. This study compares local mucoperiosteal flaps with mylohyoid flaps with special emphasis on their influence on wound healing.
  
  
  METHODS
  A total of 195 patients with BRONJ in the mandible were included in this prospective study. The control group (n = 169) were treated with a mucoperiosteal flap, whereas patients of the study group (n = 26) received a mylohyoid flap.
  
  
  RESULTS
  Recurrence of BRONJ was significantly reduced (p = 0.023) as was extent of necrosis (p = 0.001) in patients with mylohyoid flaps.
  
  
  CONCLUSIONS
  This study demonstrates the importance of a sufficient mucosal coverage in surgical treatment of BRONJ. The mylohyoid flap provides an additional tissue coverage, which seems to account for the significantly reduced rate of disease recurrence.
  
  
  CONCLUSIONS
  The vascularized mylohyoid flap is an important tool in the complex and challenging surgical care of BRONJ.
authors: Department of Oral and Maxillofacial Surgery, Technische Universität München, Klinikum Rechts der Isar, Munich, Germany. Electronic address: th.mucke@gmx.de.
authors: Thomas
authors: T
authors: Mücke
authors: Department of Oral and Maxillofacial Surgery, Technische Universität München, Klinikum Rechts der Isar, Munich, Germany.
authors: Steffen
authors: S
authors: Koerdt
authors: Department of Oral and Maxillofacial Surgery, Technische Universität München, Klinikum Rechts der Isar, Munich, Germany.
authors: Maximilian
authors: M
authors: Jung
authors: Department of Oral and Maxillofacial Surgery, Technische Universität München, Klinikum Rechts der Isar, Munich, Germany.
authors: David A
authors: DA
authors: Mitchell
authors: Department of Oral and Maxillofacial Surgery, Technische Universität München, Klinikum Rechts der Isar, Munich, Germany.
authors: Klaus-Dietrich
authors: KD
authors: Wolff
authors: Department of Oral and Maxillofacial Surgery, Technische Universität München, Klinikum Rechts der Isar, Munich, Germany.
authors: Marco Rainer
authors: MR
authors: Kesting
authors: Department of Oral and Maxillofacial Surgery, Technische Universität München, Klinikum Rechts der Isar, Munich, Germany.
authors: Denys John
authors: DJ
authors: Loeffelbein
mesh_terms: D059266:Bisphosphonate-Associated Osteonecrosis of the Jaw / Q000601:surgery*; D050071:Bone Density Conservation Agents / Q000009:adverse effects; D016022:Case-Control Studies; D004164:Diphosphonates / Q000009:adverse effects; D006801:Humans; D011446:Prospective Studies; D013524:Surgical Flaps; D016896:Treatment Outcome
chemical_list: D050071:Bone Density Conservation Agents; D004164:Diphosphonates
keywords: Bisphosphonates; Jaws; Microvascular free flap; Osteonecrosis; Recurrence; Treatment outcome