[Application of the submandibular gland for management of stage 3 medication-related osteonecrosis of the mandible].

Objective

To summarize the clinical outcomes of reconstruction plate fixation combined with submandibular gland translocation (A) or reconstruction plate fixation combined with submental island flap and submandibular gland (B) for mandibular stage-3 medication-related osteonecrosis of the jaw (MRONJ).

Methods

The clinical data of the patients with stage-3 mandibular MRONJ treated with one of the above mentioned procedures from September 2014 to December 2020 in the Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, were retrospectively reviewed. The clinical data included the general data of the patients, the initial mucosal healing rate at the time of 2 weeks postoperatively and follow-up, and the occurrence of complications.

Results

A total of 40 patients were treated, including 17 males and 23 females, aged (64.6±8.9) years. Among the patients, 33 were treated with operation A and 7 with operation B. The initial mucosal healing rate was 90% (36/40). Plate fracture occurred in 4 patients. The mean length of the mandibular bony defect was (4.5±1.4) cm (ranged from 2.1 to 8.0 cm).

Conclusions

For management of stage-3 mandibular MRONJ, reconstruction plate fixation combined with submandibular gland translocation or with submental island flap and submandibular gland might be one of the effective and reliable options.