Treatment of Medication-Related Osteonecrosis of the Jaws (MRONJ) with Topical Therapy Using Active Oxygen Gel

Tatiana Miranda Deliberador, Carlos Stutz, Elisa Sartori, Leandro Kluppel, Rubens Moreno de Freitas Department of Implantology, Master’s Program, Latin American Institute of Dental Research and Education – ILAPEO, Curitiba, PR, BrazilCorrespondence: Tatiana Miranda Deliberador, Department of Implantology, Master’s Program, Latin American Institute of Dental Research and Education – ILAPEO, Rua Jacarezinho 656, Curitiba, PR, 80710-150, Brazil, Email [email protected]: Medication-related osteonecrosis of the jaw (MRONJ) can be a debilitating complication that can arise in patients who took or are taking antiresorptive (including bisphosphonates) or antiangiogenic agents, leading to visible bone or a fistula that continues for more than eight weeks, without any history of radiotherapy. This clinical case aimed to describe the treatment of MRONJ with topical active oxygen therapy using blue®m oral gel. A 63-year-old female patient that had been taking weekly sodium alendronate (70 mg) for four years by oral via, presented discomfort and implant movement in the #46 region, by that underwent surgical extraction of the implant. After three months the patient returned and was diagnosed with MRONJ. Initially, conventional therapies were performed, including surgical debridement and antibiotic therapy, but without success. The patient still had clinical signs of osteonecrosis six months after the implant extraction. The entire socket was then filled with blue®m oral gel by topical application. The patient was instructed to continue applying the gel to the region every 8 hours for 15 days. After this period, the patient returned, and it was observed that the wound was in the healing process, with the presence of epithelialized tissue and without bone exposure. The 2-year clinical follow-up showed the lesion had healed entirely, and a new implant was installed. After the osseointegration period, the final prosthesis was placed. The patient remains under clinical follow-up. Therefore, it can be concluded that the application of blue®m oral gel in this clinical case assisted in the recovery of the osteonecrosis lesion.Keywords: osteonecrosis, bisphosphonate, jaw, reactive oxygen species, wound healing, oxyge

Comparison of conventional and semilunar coronally positioned flap techniques for root coverage in teeth with cervical abrasion restored with pink resin

Felipe Rychuv Santos,1 Carmen Lucia Mueller Storrer,1 Emanuelle Juliana Cunha,1 Lucienne M Ulbrich,1 Camilo Andress Villabona Lopez,2,3 Tatiana Miranda Deliberador1 1Department of Dentistry, Universidade Positivo, Curitiba, Paraná, Brazil; 2Department of Dentistry, University of Santo Tomás, Bucaramanga, Santander, Colombia; 3Department of Implantology, Federal University of Santa Cataria, Florianópolis, Brazil Abstract: Gingival recession is the most common mucogingival defect, characterized by apical migration of the gingival margin from the cementoenamel junction and root exposure. Several surgical techniques are reported for the treatment of gingival recession. Here we present a comparison of the conventional (coronally advanced flap) and semilunar coronally positioned flap techniques for root coverage in teeth with cervical abrasion restored with pink resin that mimics the color of the gingiva. Although the conventional technique is more predictable, we found that both techniques were effective in achieving satisfactory and esthetic root coverage. Keywords: gingival recession, root coverage, surgical flap