# A Case of Extensive Maxillary Medication‐Related Osteonecrosis of the Jaw With Wound Closure Using a Pedicled Buccal Fat Pad

## TL;DR

This paper presents a rare case of severe jaw bone death treated with a fat pad technique instead of traditional reconstruction.

## Contribution

The novel approach uses a pedicled buccal fat pad for wound closure in extensive MRONJ without jaw reconstruction.

## Key findings

- Aggressive resection of infected bone is crucial to prevent infection spread into the maxillary sinus.
- A pedicled buccal fat pad successfully closed the wound and improved oral function without reconstruction.
- This method offers an alternative for managing extensive MRONJ bone defects.

## Abstract

Reports of extensive medication‐related osteonecrosis of the jaw (MRONJ) with pedicled buccal fat pad wound closure without tissue reconstruction are rare. We present the case of a 78‐year‐old man with prostate cancer and extensive MRONJ on the left side of the maxilla. The patient was treated with denosumab for the multiple bone marrow and lymph node metastases. Aggressive resection of the infected bone should be considered to prevent the spread of the infection if it extends into the maxillary sinus. In cases of extensive removal of decayed bone, jaw reconstruction is necessary to address the bone defect because it impairs the ability to eat, speak, and communicate. However, it was possible to close the wound and improve oral function by using a pedicled buccal fat pad for extensive MRONJ without maxillary reconstruction.