Cranial Maxillofac Trauma Reconstruction 2017; 10(04): 299-305
DOI: 10.1055/s-0036-1593472
Case Report
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Submental Perforator Flap for Soft-Tissue Reconstruction in Bisphosphonate-Related Osteonecrosis of the Jaws

Jose-Antonio García-de Marcos1, Juan Rey-Biel1
  • 1Department of Oral and Maxillofacial Surgery, Hospital Rey Juan Carlos Ringgold Standard Institution, Mostoles, Spain
Further Information

Publication History

19 July 2016

07 August 2016

Publication Date:
01 November 2016 (eFirst)


Bisphosphonate-related osteonecrosis of the jaws (BRONJ) has emerged as an important and increasingly common comorbidity, especially in patients undergoing long-term treatment with high doses of bisphosphonates. The management of BRONJ remains controversial. Surgical treatment is necessary in severe cases. Treatment of the bone requires sequestrectomy or resection. Given the lack of sufficient mucosa to perform the operation and fragility of margins in many patients, local flaps are crucial. We report two cases of stage-3 BRONJ presenting secondary infection with Actinomyces, receiving treatment consisting of marginal resection of the necrotic bone, reinforcement with a reconstruction plate, and reconstruction of soft tissues using a submental perforator artery flap ipsilateral to the lesion. Total cure was achieved in both cases, achieving favorable aesthetic and functional outcomes.