Department of Oral & Maxillofacial Surgery, Copenhagen University Hospital, Blegdamsvej 9, 2100, Copenhagen, Denmark.
Department of Clinical Epidemiology, Aarhus University Hospital, Olof Palmes Allé 43-45, 8200, Aarhus, Denmark.
Oral Maxillofac Surg. 2023 Jun;27(2):251-261. doi: 10.1007/s10006-022-01061-2. Epub 2022 Apr 1.
Buccal fat pad (BFP) is used for the closure of large oroantral defects caused by surgical removal of the necrotic bone in patients with medication-related osteonecrosis of the jaw (MRONJ). This study aimed to evaluate the use of BFP for the closure of maxillary sinus defects in stage 3 MRONJ patients.
This study recruited 61patients with large oroantral defects caused by MRONJ, including 49 patients with cancer and 12 patients with osteoporosis. Lesions were evaluated clinically and radiographically.
Among the 61 patients, 51 (83.6%) healed uneventfully, and 5 patients (8.2%) had local dehiscence and exposed bone; these 56 patients (91.8%) all healed after first or second operation. The Eastern Cooperative Oncology Group Performance Status was associated with being non-cured and might be an indicator for the healing process. All patients experienced a significant increase in body weight postoperatively.
This study suggest that block resection with removal of the necrotic bone combined with radical sinusotomy and closure of the defect with BFP is a reliable method to cure MRONJ lesions with a high success rate, and successful operation and prosthetic rehabilitation may improve body weight and the quality of life. The study was approved by the appropriate ethical approval for the Copenhagen ONJ Cohort (protocol no. H-6-2013-010) November 20, 2013.
颊脂垫（BFP）用于闭合因手术切除颌骨坏死性骨而导致的大口腔上颌窦缺损，这些患者患有药物相关性颌骨坏死（MRONJ）。本研究旨在评估颊脂垫在 3 期 MRONJ 患者上颌窦缺损中的应用。
本研究纳入了 61 例因 MRONJ 导致的大口腔上颌窦缺损患者，包括 49 例癌症患者和 12 例骨质疏松症患者。对病变进行临床和影像学评估。
在 61 例患者中，51 例（83.6%）无并发症愈合，5 例（8.2%）局部裂开并暴露骨质；这 56 例（91.8%）患者均经首次或第二次手术后愈合。东部肿瘤协作组表现状态与未治愈相关，可能是愈合过程的一个指标。所有患者术后体重均显著增加。
本研究表明，采用骨块切除术切除坏死骨，联合根治性窦切开术，并使用颊脂垫封闭缺损，是治疗 MRONJ 病变的一种可靠方法，成功率高，成功的手术和修复治疗可能改善体重和生活质量。本研究于 2013 年 11 月 20 日经哥本哈根 ONJ 队列研究（协议编号 H-6-2013-010）获得了适当的伦理批准。
