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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.

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Presentation on theme: "Treatment of Avascular Osteonecrosis of the Mandible in Cancer Patients With a History of Bisphosphonate Therapy by Combining Bone Resection and Autologous."— Presentation transcript:

1 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 (February 2007) DOI: /j.joms Copyright © 2007 American Association of Oral and Maxillofacial Surgeons Terms and Conditions

2 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  , DOI: ( /j.joms ) Copyright © 2007 American Association of Oral and Maxillofacial Surgeons Terms and Conditions

3 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  , DOI: ( /j.joms ) Copyright © 2007 American Association of Oral and Maxillofacial Surgeons Terms and Conditions

4 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  , DOI: ( /j.joms ) Copyright © 2007 American Association of Oral and Maxillofacial Surgeons Terms and Conditions

5 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  , DOI: ( /j.joms ) Copyright © 2007 American Association of Oral and Maxillofacial Surgeons Terms and Conditions

6 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  , DOI: ( /j.joms ) Copyright © 2007 American Association of Oral and Maxillofacial Surgeons Terms and Conditions

7 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  , DOI: ( /j.joms ) Copyright © 2007 American Association of Oral and Maxillofacial Surgeons Terms and Conditions

8 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  , DOI: ( /j.joms ) Copyright © 2007 American Association of Oral and Maxillofacial Surgeons Terms and Conditions

9 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  , DOI: ( /j.joms ) Copyright © 2007 American Association of Oral and Maxillofacial Surgeons Terms and Conditions

10 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  , DOI: ( /j.joms ) Copyright © 2007 American Association of Oral and Maxillofacial Surgeons Terms and Conditions

11 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  , DOI: ( /j.joms ) Copyright © 2007 American Association of Oral and Maxillofacial Surgeons Terms and Conditions

12 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  , DOI: ( /j.joms ) Copyright © 2007 American Association of Oral and Maxillofacial Surgeons Terms and Conditions

13 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  , DOI: ( /j.joms ) Copyright © 2007 American Association of Oral and Maxillofacial Surgeons Terms and Conditions

14 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  , DOI: ( /j.joms ) Copyright © 2007 American Association of Oral and Maxillofacial Surgeons Terms and Conditions

15 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  , DOI: ( /j.joms ) Copyright © 2007 American Association of Oral and Maxillofacial Surgeons Terms and Conditions

16 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  , DOI: ( /j.joms ) Copyright © 2007 American Association of Oral and Maxillofacial Surgeons Terms and Conditions

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