Department of Oral and Maxillofacial Surgery, University of Munich, Lindwurmstr. 2a, D-80337 Munich, Germany.
Oral Oncol. 2011 May;47(5):425-9. doi: 10.1016/j.oraloncology.2011.03.022. Epub 2011 Apr 7.
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.
颌骨骨坏死（BRONJ）是一种可能由于长期双膦酸盐治疗而出现的副作用。虽然及时诊断和开始治疗与良好的结果相关，但扩展病例需要切除整个颌骨部分。一种可能的治疗选择是使用微血管骨瓣进行颌骨重建。我们首次报告了在微血管髂骨移植物中发生的与双膦酸盐相关的骨坏死，这是由于 BRONJ Ⅲ期进行部分下颌骨切除术而进行的重建。在骨微血管移植中观察到 BRONJ 表现是一个新发现，为当前围绕该实体的发病机制理论提供了新的认识。此外，据推测 BRONJ 能够进展到相邻的骨骼。此外，患有 BRONJ 的患者的骨重建可能会受到更严格的关注。
