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    Clinical Evaluation of the Use of Tibial Bone Grafting in Dentoalveolar Reconstructive Surgery
    (Karger, 2016) Atil, Fethi; Kocyigit, Ismail Doruk; Suer, Berkay Tolga; Alp, Yunus Emre; Yazan, Murude; Tekin, Umut; Tuz, Hakan H.
    Objective: The aim of this study was to evaluate the efficacy of tibial autogenous bone grafting in the treatment of patients with alveolar bone defects. Materials and Methods: The study subjects consisted of 12 patients (10 male, 2 female, age: 19-51 years) who underwent reconstructive autogenous bone-grafting procedures. The medial approach to the tibial bone was used to harvest autogenous cancellous bone grafts in all the patients. Clinical parameters (complications at the donor and recipient sites, resorption and volume of the grafts) were evaluated retrospectively. Results: The mean age of the patients was 36.25 +/- 0.9 years. Of the 12 patients, 5 (41.7%) received bone grafts for sinus augmentation, 3 (25%) for cyst cavity reconstruction and 4 (33.3%) for alveolar cleft reconstruction procedures. The average follow-up period was 28.4 months (range: 21-40 months). An average of 5.2 cm(3) of cancellous bone was harvested for grafting procedures. All the grafting procedures were successful, and there were no surgical complications during the harvesting protocol. In all cases, pain and gait disturbance lasted less than 2 weeks. Conclusion: The results of this study suggest that the use of tibial autogenous bone graft harvested using a medial approach was a safe, simple and effective method for grafting various alveolar bone defects where high amounts of cancellous bone grafts were needed with low morbidity. (C) 2015 S. Karger AG, Basel
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    Spontaneous Healing of Mandibular Noncontinuous Defect Caused by Medication-Related Osteonecrosis of the Jaw
    (Lippincott Williams & Wilkins, 2016) Yazan, Murude; Atil, Fethi; Kocyigit, Ismail Doruk; Tekin, Umut; Tuz, Hakan Hifzi; Misirlioglu, Melda
    Background: Bisphosphonates are used throughout supportive cancer therapies for the treatment of osteoporosis and metastatic bone diseases, but they invariably induce medication-related osteonecrosis of the jaw (MRONJ). This medicational modality may induce consequential losses that can lead to spontaneous or surgical therapy related bone fractures or defects. MRONJ stages and treatment alternatives are described in the current procedures. Accordingly, treatments for stages 0 and 1 are conservative whereas the treatment for stage 3 is surgical resection of the necrotic bone. Stage III MRONJ therapy is still controversial within the scope of conceivable bone fractures or defects. When the development of MRONJ is refractory to conventional treatment modalities, surgical management can be suggested. The aim of this study was to evaluate the results of the surgical treatment of MRONJ as part of a medical patient. Methods: A 72-year-old man was referred to our department for extensive pain of the left mandibular region that occurred after tooth extraction. It was identified in his medical history that he had received a nitrogen-containing intravenous bisphosphonate (Zometa; Novartis, East Hanover, NJ) therapy for prostate cancer. He had been administered 4 mg. IV Zolenat 9 times during the first year of therapy, followed by 2 doses of the same amount of Zolenat in the second year. Results: The treatment started with a therapy that combined antibiotics and antibacterial mouth rinse with chlorhexidine for maintaining oral hygiene. After the maturity of the sequestrum was identified through radiographic examination, the patient was treated by the segmental resection of the extensive necrotic bone, resulting in discontinuity of the mandibular corpus. Two years later, spontaneous bone healing occurred along the residual defect on the mandible. Conclusion: Treatment options for the defects resulting from MRONJ are still under debate, and no evidence-based guidelines are available. However, due to the results displayed in this patient; it may be a sound approach to closely follow up and observe MRONJ-related bone to prevent additional complications.