Background. An increasing number of cases of
osteonecrosis of the jaws (ONJ) in patients treated with
bisphosphonates has been reported in the literature. ONJ significantly
affects the patients’ quality of life and its management
is still extremely difficult.
Methods. A woman with ONJ secondary to therapy with
zoledronic acid came to our attention for recurrent oral infections
and orocutaneous fistula unresponsive to antibiotic therapy
combined with minor surgical debridements. The patient
underwent major surgery to remove the fistula and clean the
necrotic bone and soft tissues; a lobed skin platysma flap was
used to close the defect. The treatment outcome was good.
Conclusion. When ONJ fails to respond to antibiotic therapy
and surgical debridements, a more invasive surgical
approach may be necessary to guarantee a better quality of
life for the patient.
