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Osteonecrosis of the jaws (ONJ) due to the use of bisphosphonate drugs is a particularly complex condition. The mechanisms through which this pathology develops are manifold. To date, the management of ONJ is controversial. This study analyzed out-patients with documented ONJ treated in Oral and maxillofacial surgery Unit of University “Magna Graecia” of Catanzaro. A total of 11 patients, 8 women and 3 men, were enrolled. The inclusion criteria were: (1) refusal to surgical treatment with flaps; (2) absence of antiplatelet therapy which would also make it impossible to prepare gel from platelet-rich plasma (PRP) or similar; (3) absence of antiblastic therapy in the healing phase. Each case was staged according to the classification of the Italian Societies of Oral Medicine and Maxillofacial Surgery (SICMF-SIPMO classification): a clinical-radiological bone involvement. The following data were recorded: clinical data, comorbidities and concomitant drugs, antibiotic drugs used, type of treatment adopted, clinical mucosal healing time. Each patient underwent antibiotic protocol prior to surgery. Endpoint with surgery was: complete removal of necrotic tissues, packaging of a “re-epithelialization trench” (RET) and apposition of a compress of oxidized cellulose inside this RET. 100% of the patients endured the post-surgery very well, 10 out of 11 (90,91%) patients had excellent healing by secondary intention of the surgical wound. Only one patient (9.09%) had prolonged bone exposure; he subsequently resumed antiblastic therapy and was therefore excluded from work. The results indicate how the use of an oxidized cellulose pack associated with the correct packaging of a re-epithelialization site can guarantee satisfactory post-operative comfort and rapid wound healing. Radiological follow-up was performed at one year. It confirmed the correct healing of the site (clinical and radiological healing).

OXIDIZED CELLULOSE WRAP IN SECONDARY INTENTION HEALING OF THE ORAL MUCOSA IN THE TREATMENT OF ONJ