Case Report: Surgical treatment of stage 3 medication-related osteonecrosis of the maxilla using the “FTT Split” surgical protocol: a report of 14 cases

Most severe presentation of medication-related osteonecrosis of the jaw (MRONJ) is classified as stage 3 for which there are still no standard surgical therapy guideline. Our aim was to describe "Five Times Three (FTT) Split" protocol as surgical treatment of stage 3 maxillary MRONJ. The present case series included a total of 14 patients diagnosed with stage 3 MRONJ of the upper jaw who were treated from February 2022 to September 2024 with mucoperiosteal flap and "FTT Split" protocol. The patients were followed up both clinically and radiologically for a period ranging from 9 months to 3 years. Primary wound closure was successfully achieved in all cases without any signs of oroantral or oronasal communication, and complete healing was observed during the postoperative follow-up period. The "FTT Split" surgical protocol demonstrated high success rates during a controlled postoperative period.