Rehabilitation after surgical interventions in bisphosphonate related lower jaw osteonecrosis

The purpose of this study is to enhance the quality of life for patients who have undergone surgical procedures for osteonecrosis in the maxillofacial region by refining approaches to surgical intervention planning and rehabilitation, with an emphasis on restoring chewing function. The study analyzed methods for treating medication-induced osteonecrosis of the jaw and explored options for restoring lost functions. Nine patients diagnosed with this condition were examined, each undergoing a standard dental examination and computed tomography. In the first stage of rehabilitation, patients received dietary guidance, recommendations on individual oral hygiene, myogymnastics, and instructions for maintaining a proper rest regimen. The second stage included orthopedic rehabilitation and the continuation of myogymnastics. Six months after the start of rehabilitation, patients exhibited moderate facial asymmetry due to soft tissue deformation in the lower third of the face resulting from bone deficiency. In the submandibular area, a pale pink scar without discharge was observed. Bimanual palpation along the plate fixation area revealed a firm, elastic mass of soft tissues, with no exposed bone tissue found in the oral cavity. Full restoration of chewing function was not achieved. The findings underscore the necessity for developing new approaches and improving existing methods for planning rehabilitation measures. A well-structured, multidisciplinary rehabilitation plan with active patient involvement is essential for achieving successful postoperative outcomes.