NUMERO: #20250220

Título: MYOCUTANEOUS FLAP AND SEQUESTRECTOMY IN THE TREATMENT OF SEVERE MEDICATION-RELATED OSTEONECROSIS OF THE JAW

Nome do Apresentador: João Pedro Pereira da fé BRAGA

Categoria do Trabalho: Painel de caso clínico (PCC)

Área Temática: Cirurgia e traumatologia bucomaxilofacial

Resumo: Medication-related osteonecrosis of the jaw (MRONJ) is a complication linked to antiresorptive drugs and invasive oral procedures. This report describes a 71-year-old woman using risedronate who presented with mandibular pain and infection after implant placement a year earlier. Initial treatment included low-level laser therapy, bone grafting, and L-PRF membrane application, but the infection persisted. Examination revealed bone exposure, purulent drainage, crepitus, and bone sequestration. A CT confirmed osteonecrosis with pathological fracture. Surgical resection and mandibular reconstruction with a myocutaneous vascular flap were performed, along with antibiotic therapy. The patient recovered well, showing no signs of infection or osteonecrosis over a two-year follow-up. This case emphasizes the importance of evaluating patients medication history and carefully weighing the risks of invasive dental procedures, as the management of MRONJ can be complex and potentially mutilating. Dental professionals must remain vigilant when treating patients on long-term antiresorptive therapies.

Autor 1:  João Pedro Pereira da fé BRAGA

E-mail 1:  [email protected]

Autor 2:   Marcio Bruno Figueiredo AMARAL

E-mail 2: 

Autor 3 :  Samuel Macedo COSTA

E-mail 3: 

Autor 4:  Bruna Campos RIBEIRO

E-mail 4: 

Autor 5:  Giovanna GUIMARÃES Santos do Nascimento

E-mail 5:  [email protected]