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Case Reports
. 2023 Mar 6;15(3):e35833.
doi: 10.7759/cureus.35833. eCollection 2023 Mar.

Application of a Dermal Regeneration Matrix for the Surgical Treatment of an Oromaxillary Defect in Medication-Related Osteonecrosis of the Jaw

Rui Seixas  1   2 , Natacha Ribeiro  1 , Ana Filipa Augusto  3 , Carlos Matos  1 , Manuel Tolentino  1
Affiliations
Case Reports

Application of a Dermal Regeneration Matrix for the Surgical Treatment of an Oromaxillary Defect in Medication-Related Osteonecrosis of the Jaw

Rui Seixas et al. Cureus. .

Abstract

Surgical options for managing patients with medication-related osteonecrosis of the jaw are multiple and may range from superficial debridement to vascularized osteocutaneous free flaps. However, some protocols may not be an option in specific cases, and alternative techniques for patients who are not likely candidates for more invasive procedures may represent a suitable solution to treat these patients. Here, we report the case of a 69-year-old man who presented to the Stomatology Department with dysphagia, exposed bone, and mild mandibular pain for the past three months. The patient was diagnosed with stage III medication-related osteonecrosis of the jaw. Surgical debridement with sequestrum removal was performed and the remaining intraoral defect, which was unsuitable for primary closure, was addressed with a dermal regeneration matrix. This system allowed full coverage of the surgical wound. At 10 weeks of follow-up, the intraoral defect had healed completely with no need for active intervention. Dermal regeneration matrixes may represent a surgical approach to cover oromaxillary defects in select patients.

Keywords: bisphosphonates; dermal regeneration matrix; jaw osteonecrosis; mronj; oromaxillary defect.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Preoperative clinical evaluation revealing exposed bone at the lower right molar region.
Figure 2
Figure 2. On axial CT in the bone window setting, a lytic lesion with sequestrum formation (arrow) can be seen in the posterior region of the right body of the mandible.
R = right
Figure 3
Figure 3. Oromaxillary defect after debridement of necrotic bone tissue.
Figure 4
Figure 4. IDRT overlying the defect seven-day post-operation.
IDRT = Integra® Dermal Regeneration Template
Figure 5
Figure 5. Full mucosal healing at 10 weeks after IDRT removal.
IDRT = Integra® Dermal Regeneration Template
See this image and copyright information in PMC

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