Department of Oral and Maxillofacial Surgery (Chair: Prof. Dr. Dr. M. Ehrenfeld), Ludwig-Maximilians University, Lindwurmstraße 2a, München 80337, Germany.
J Craniomaxillofac Surg. 2013 Oct;41(7):694-8. doi: 10.1016/j.jcms.2013.05.038. Epub 2013 Jul 5.
Osteonecrosis of the jaw has recently been described in patients receiving subcutaneous administration of RANKL-inhibitors (denosumab). However, due to promising study results, more patients will receive denosumab in order to avoid skeletal complications due to metastatic bone disease and osteoporosis. Therefore, this has the potential to become a comparable challenge to the bisphosphonate induced jaw necrosis in the area of Oral and Maxillofacial Surgery. Indeed, so far no convincing surgical technique has been described to overcome the non-healing mucosal lesions with exposed bone due to RANKL-inhibitor therapy. In this technical note, we report two successful cases of surgical treatment of jaw-bone necrosis under RANKL-inhibitor treatment using fluorescence guided bone resection. In conclusion, the technique is suggested as treatment option for this entity of osteonecrosis of the jaw.
颌骨坏死最近在接受 RANKL 抑制剂（地舒单抗）皮下给药的患者中被描述。然而，由于研究结果很有前景，为了避免因转移性骨病和骨质疏松症而导致的骨骼并发症，将有更多的患者接受地舒单抗治疗。因此，这有可能成为口腔颌面外科中与双膦酸盐引起的颌骨坏死相媲美的挑战。事实上，到目前为止，还没有令人信服的手术技术可以克服因 RANKL 抑制剂治疗而导致的暴露骨的不可愈合的粘膜病变。在本技术说明中，我们报告了两例成功的使用荧光引导骨切除治疗 RANKL 抑制剂治疗下颌骨坏死的病例。总之，该技术被建议作为颌骨骨坏死的一种治疗选择。
