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Volume 13
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Case Report

Demineralized Dentin Matrix Incorporated with rhBMP-2 Composite Graft for Treating Medication-Related Osteonecrosis of the Jaw

by
Jeong-Kui Ku
1,
Jin-Won Choi
1,
Seung-Min Song
1,
Pil-Young Yun
1,2,
In-Woong Um
3 and
Dae Ho Leem
4,*
1
Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul National University Bundang Hospital, 172, Dolma-ro, Bundang-gu, Seongnam-si 13605, Republic of Korea
2
Department of Dentistry and Dental Research Institute, School of Dentistry, Seoul National University, Seoul 01811, Republic of Korea
3
R&D Institute, Korea Tooth Bank, Seoul 06101, Republic of Korea
4
Department of Oral and Maxillofacial Surgery, School of Dentistry and Institute of Oral Bioscience, Research Institute of Clinical Medicine of Jeonbuk National University, Biomedical Research Institute of Jeonbuk National University Hospital, Jeonbuk National University, Jeonju 54907, Republic of Korea
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2024, 13(16), 4830; https://doi.org/10.3390/jcm13164830
Submission received: 2 July 2024 / Revised: 22 July 2024 / Accepted: 13 August 2024 / Published: 16 August 2024
(This article belongs to the Special Issue Current Challenges in Oral Surgery)
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Abstract

Medication-Related Osteonecrosis of the Jaw (MRONJ) is characterized by bone exposure in the oral and maxillofacial region for more than eight weeks in patients treated with anti-resorptive agents, immunosuppressants, or anti-angiogenic agents, without prior radiation therapy or metastatic disease to the jaws. Conservative treatments can control infection in mild cases, but surgical intervention is necessary for patients with severe symptoms. A 78-year-old female with a history of bisphosphonate treatment for osteoporosis presented with persistent pain, swelling, and malodor following implant placement in the upper right maxilla. SPECT/CT imaging revealed a high-risk hot spot in the right maxillary region. BIS-guided surgery using the Qray pen-C was performed, selectively removing red fluorescent bone tissue. The defect was grafted with HuBT incorporated with rhBMP-2. Postoperative follow-ups at 4, 7, and 14 months showed successful bone healing, transforming into a corticocancellous complex, and implant placement without MRONJ recurrence. Allogeneic demineralized dentin matrix (DDM) incorporated with rhBMP-2 demonstrates effective bone healing and implant placement following BIS-guided MRONJ surgery. This case supports the use of DDM/rhBMP-2 for tissue regeneration in MRONJ treatment, enabling successful prosthetic restoration without recurrence.
Keywords: biofluorescence imaging system; bone regeneration; dental implants; demineralized dentin matrix; medication related osteonecrosis of the jaw biofluorescence imaging system; bone regeneration; dental implants; demineralized dentin matrix; medication related osteonecrosis of the jaw

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MDPI and ACS Style

Ku, J.-K.; Choi, J.-W.; Song, S.-M.; Yun, P.-Y.; Um, I.-W.; Leem, D.H. Demineralized Dentin Matrix Incorporated with rhBMP-2 Composite Graft for Treating Medication-Related Osteonecrosis of the Jaw. J. Clin. Med. 2024, 13, 4830. https://doi.org/10.3390/jcm13164830

AMA Style

Ku J-K, Choi J-W, Song S-M, Yun P-Y, Um I-W, Leem DH. Demineralized Dentin Matrix Incorporated with rhBMP-2 Composite Graft for Treating Medication-Related Osteonecrosis of the Jaw. Journal of Clinical Medicine. 2024; 13(16):4830. https://doi.org/10.3390/jcm13164830

Chicago/Turabian Style

Ku, Jeong-Kui, Jin-Won Choi, Seung-Min Song, Pil-Young Yun, In-Woong Um, and Dae Ho Leem. 2024. "Demineralized Dentin Matrix Incorporated with rhBMP-2 Composite Graft for Treating Medication-Related Osteonecrosis of the Jaw" Journal of Clinical Medicine 13, no. 16: 4830. https://doi.org/10.3390/jcm13164830

APA Style

Ku, J.-K., Choi, J.-W., Song, S.-M., Yun, P.-Y., Um, I.-W., & Leem, D. H. (2024). Demineralized Dentin Matrix Incorporated with rhBMP-2 Composite Graft for Treating Medication-Related Osteonecrosis of the Jaw. Journal of Clinical Medicine, 13(16), 4830. https://doi.org/10.3390/jcm13164830

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