Treatment of Avascular Osteonecrosis of the Mandible in Cancer Patients With a History of Bisphosphonate Therapy by Combining Bone Resection and Autologous.

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Treatment of Avascular Osteonecrosis of the Mandible in Cancer Patients With a History of Bisphosphonate Therapy by Combining Bone Resection and Autologous Platelet- Rich Plasma: Report of 3 Cases Marcos Martins Curi, DDS, PhD, Giuliano Saraceni Issa Cossolin, DDS, MDS, Daniel Henrique Koga, DDS, Sérgio Rocha Araújo, MD, PhD, Olavo Feher, MD, Marcelo Oliveira dos Santos, MD, Cristina Zardetto, DDS, PhD Journal of Oral and Maxillofacial Surgery Volume 65, Issue 2, Pages 349-355 (February 2007) DOI: 10.1016/j.joms.2005.12.051 Copyright © 2007 American Association of Oral and Maxillofacial Surgeons Terms and Conditions

Figure 1 Intraoral view showing exposed necrotic bone on the lingual cortex of the mandible. Curi et al. Avascular Osteonecrosis and PRP. J Oral Maxillofac Surg 2007. Journal of Oral and Maxillofacial Surgery 2007 65, 349-355DOI: (10.1016/j.joms.2005.12.051) Copyright © 2007 American Association of Oral and Maxillofacial Surgeons Terms and Conditions

Figure 2 Axial computed tomography scan showing extensive mandibular erosion involving the lingual cortical plate and the medullary space of the mandible. Curi et al. Avascular Osteonecrosis and PRP. J Oral Maxillofac Surg 2007. Journal of Oral and Maxillofacial Surgery 2007 65, 349-355DOI: (10.1016/j.joms.2005.12.051) Copyright © 2007 American Association of Oral and Maxillofacial Surgeons Terms and Conditions

Figure 3 Intraoperative view showing marginal resection of the necrotic bone area in the mandible. Curi et al. Avascular Osteonecrosis and PRP. J Oral Maxillofac Surg 2007. Journal of Oral and Maxillofacial Surgery 2007 65, 349-355DOI: (10.1016/j.joms.2005.12.051) Copyright © 2007 American Association of Oral and Maxillofacial Surgeons Terms and Conditions

Figure 4 Radiograph showing healing of the mandible 6 months after bone resection and PRP. Curi et al. Avascular Osteonecrosis and PRP. J Oral Maxillofac Surg 2007. Journal of Oral and Maxillofacial Surgery 2007 65, 349-355DOI: (10.1016/j.joms.2005.12.051) Copyright © 2007 American Association of Oral and Maxillofacial Surgeons Terms and Conditions

Figure 5 Intraoral view showing exposed necrotic bone in the mandible initiated by a tooth extraction. Curi et al. Avascular Osteonecrosis and PRP. J Oral Maxillofac Surg 2007. Journal of Oral and Maxillofacial Surgery 2007 65, 349-355DOI: (10.1016/j.joms.2005.12.051) Copyright © 2007 American Association of Oral and Maxillofacial Surgeons Terms and Conditions

Figure 6 Panoramic radiograph showing diffuse rarefaction in the alveolus bone on the right body of the mandible. Curi et al. Avascular Osteonecrosis and PRP. J Oral Maxillofac Surg 2007. Journal of Oral and Maxillofacial Surgery 2007 65, 349-355DOI: (10.1016/j.joms.2005.12.051) Copyright © 2007 American Association of Oral and Maxillofacial Surgeons Terms and Conditions

Figure 7 Panoramic radiograph showing diffuse rarefaction in the right body of the mandible with clear evidence of sequestrum formation. Curi et al. Avascular Osteonecrosis and PRP. J Oral Maxillofac Surg 2007. Journal of Oral and Maxillofacial Surgery 2007 65, 349-355DOI: (10.1016/j.joms.2005.12.051) Copyright © 2007 American Association of Oral and Maxillofacial Surgeons Terms and Conditions

Figure 8 Intraoperative view showing marginal resection of the necrotic bone in the mandible. Curi et al. Avascular Osteonecrosis and PRP. J Oral Maxillofac Surg 2007. Journal of Oral and Maxillofacial Surgery 2007 65, 349-355DOI: (10.1016/j.joms.2005.12.051) Copyright © 2007 American Association of Oral and Maxillofacial Surgeons Terms and Conditions

Figure 9 Panoramic radiograph taken 6 months after the marginal resection in the right body of the mandible showing partial bone healing. Curi et al. Avascular Osteonecrosis and PRP. J Oral Maxillofac Surg 2007. Journal of Oral and Maxillofacial Surgery 2007 65, 349-355DOI: (10.1016/j.joms.2005.12.051) Copyright © 2007 American Association of Oral and Maxillofacial Surgeons Terms and Conditions

Figure 10 Intraoral view showing exposed necrotic bone in the mandible and erythema of the surrounding soft tissues. Curi et al. Avascular Osteonecrosis and PRP. J Oral Maxillofac Surg 2007. Journal of Oral and Maxillofacial Surgery 2007 65, 349-355DOI: (10.1016/j.joms.2005.12.051) Copyright © 2007 American Association of Oral and Maxillofacial Surgeons Terms and Conditions

Figure 11 Panoramic radiograph showing a diffuse rarefaction in the right body of the mandible. Curi et al. Avascular Osteonecrosis and PRP. J Oral Maxillofac Surg 2007. Journal of Oral and Maxillofacial Surgery 2007 65, 349-355DOI: (10.1016/j.joms.2005.12.051) Copyright © 2007 American Association of Oral and Maxillofacial Surgeons Terms and Conditions

Figure 12 Intraoperative view showing osteotomies during the marginal resection in the mandible. Curi et al. Avascular Osteonecrosis and PRP. J Oral Maxillofac Surg 2007. Journal of Oral and Maxillofacial Surgery 2007 65, 349-355DOI: (10.1016/j.joms.2005.12.051) Copyright © 2007 American Association of Oral and Maxillofacial Surgeons Terms and Conditions

Figure 13 Intraoperative view showing the remaining mandibular bone ready to receive the PRP. Curi et al. Avascular Osteonecrosis and PRP. J Oral Maxillofac Surg 2007. Journal of Oral and Maxillofacial Surgery 2007 65, 349-355DOI: (10.1016/j.joms.2005.12.051) Copyright © 2007 American Association of Oral and Maxillofacial Surgeons Terms and Conditions

Figure 14 Panoramic radiograph taken 8 months after the marginal resection in the right body of the mandible showing partial bone healing. Curi et al. Avascular Osteonecrosis and PRP. J Oral Maxillofac Surg 2007. Journal of Oral and Maxillofacial Surgery 2007 65, 349-355DOI: (10.1016/j.joms.2005.12.051) Copyright © 2007 American Association of Oral and Maxillofacial Surgeons Terms and Conditions

Figure 15 Intraoral view showing healing of the oral mucosa at the surgical site 8 months after marginal resection. Curi et al. Avascular Osteonecrosis and PRP. J Oral Maxillofac Surg 2007. Journal of Oral and Maxillofacial Surgery 2007 65, 349-355DOI: (10.1016/j.joms.2005.12.051) Copyright © 2007 American Association of Oral and Maxillofacial Surgeons Terms and Conditions