Hino Kiyosato, Kikuta Shogo, Kusukawa Jingo
Dental and Oral Medicine, Kurume University School of Medicine, Kurume, JPN.
Cureus. 2025 Aug 4;17(8):e89370. doi: 10.7759/cureus.89370. eCollection 2025 Aug.
Segmental mandibulectomy is a valid treatment for advanced medication-related osteonecrosis of the jaw (MRONJ), but subsequent reconstruction is challenging. Spontaneous bone regeneration (SBR) following resection is exceedingly rare, particularly in the elderly. We present the case of a 63-year-old woman with stage 3 MRONJ who underwent a 60 mm segmental mandibulectomy. The defect was reconstructed with a titanium plate, with meticulous preservation of the periosteum. Over a three-year follow-up period, serial imaging demonstrated progressive and substantial bone regeneration along the plate, resulting in a robust, continuous mandibular segment without any bone grafting. This case highlights that SBR, a phenomenon metaphorically termed the "Phoenix jaw," can occur even in older patients with advanced MRONJ, challenging conventional expectations regarding bone regeneration in this patient population.
节段性下颌骨切除术是治疗晚期药物相关性颌骨坏死（MRONJ）的有效方法，但后续重建具有挑战性。切除术后的自发性骨再生（SBR）极为罕见，尤其是在老年人中。我们报告了一例63岁患有3期MRONJ的女性患者，她接受了60毫米节段性下颌骨切除术。缺损用钛板重建，骨膜得到精心保留。在三年的随访期内，系列影像学检查显示沿钛板有渐进性且大量的骨再生，形成了坚固、连续的下颌骨节段，无需任何骨移植。该病例表明，即使是患有晚期MRONJ的老年患者也可能发生SBR，这一现象被形象地称为“凤凰颌”，挑战了对该患者群体骨再生的传统预期。
