Combined reconstruction plate fixation and submandibular gland translocation for the management of medication-related osteonecrosis of the mandible.

The aim of this study was to summarize the clinical outcomes of patients with stage 3 mandibular medication-related osteonecrosis of the jaw (MRONJ) treated using reconstruction plate fixation and ipsilateral submandibular gland translocation after mandibulectomy. The medical records of patients with stage 3 mandibular MRONJ treated using the above surgical method between September 2014 and July 2019 were reviewed. Of a total of 27 patients included in this study, 23 (85.2%) experienced primary wound healing. The remaining four patients developed wound dehiscence and infection within 1 week after the operation. Three of these patients recovered after the plate was removed, and one patient died of the primary cancer. The follow-up period ranged from 3 months to 5 years, with an average of 12.7 months. The 23 patients with primary wound healing had a symmetrical facial appearance, with normal mouth opening and occlusion. Plate fracture occurred in two patients at 1year and 3 years after the operation. Radioisotope scanning in 10 patients showed that the function of the translocated submandibular gland was normal at 6 months after the operation. In summary, for patients with stage 3 MRONJ involving the mandibular angle and/or body, reconstruction plate fixation and submandibular gland translocation after segmental mandibulectomy is an effective treatment method.