Extraplatysmal reconstructive plate for the surgical treatment of mandible osteonecrosis of the jaw: our experience in 20 patients.

OBJECTIVES

In cases of high risk of mandibular fracture in patients affected by osteonecrosis, bone fixation using an extraplatysmal reconstructive plate can provide adequate load-bearing strength to the residual mandible and avoid direct communication between the fixation devices and the intra-oral site.

STUDY

DESIGN

From 2013 to 2024, 20 patients underwent surgical curettage of the necrotic bone and inset of an extraplatysmal 2.5-mm reconstructive locking plate.

RESULTS

After surgery, no major complications occurred. After a mean follow-up time of 20.9 months, 15 patients were disease-free, and no infection or exposure of the plate was observed. In 2 patients, local progression was observed, and a further surgical curettage was performed, without the need for plate removal. In 1 patient, local progression was identified, and a clinical wait-and-see strategy was adopted. In 2 patients, local progression led to segmental mandibulectomy and plate removal without any reconstructive strategy. All patients are still alive and in good general health conditions.

CONCLUSIONS

The technique is safe, with a low morbidity rate; patients with poor general clinical conditions can undergo this kind of surgery, because it allows surgeons to perform effective surgical curettage and reduces the risk of fractures.