Avascular osteonecrosis of the jaw (ONJ) may occur as a consequence of several conditions, even including chemotherapy treatment in patients affected by tumors or osteoporosis. We report our clinical experience in treating bisphosphonate-induced ONJ with a therapeutic methodology that includes ozone therapy as a new and original approach for the clinical management of maxillary necrotic lesions. Of 58 patients with ONJ observed at our department, 33 gave their informed consent to be part of the research and were treated according to a therapeutic approach, which included noninvasive surgery associated with pre- and postsurgical cycles of ozone therapy consisting of eight sessions lasting 3 minutes each besides antibiotic and antifungal therapies. Outcomes showed how ozone therapy increases the benefits of surgical and pharmacologic treatments, increasing the complete healing of the lesions with the disappearance of symptoms and brings cases of lesion progression down to zero. In conclusion, ozone therapy is a reliable presidium in treatment of ONJ; its benefits are remarkable and improve significantly the outcomes of the surgical approach.

It is certain that oral extractive surgery is a remarkable trigger to avascular osteonecrosis of the jaw in patients treated with pyrophosphate analogous. This acquisition limits the use of endo-oral surgery in those patients, even when they have already developed the lesions. In this study, we present the results obtained in a group of 15 patients deriving from a 33-patient cluster with osteonecrosis of the jaw in treatment at our department with a new protocol based on ozone therapy. The object of this article is to demonstrate how dental extraction becomes possible in a patient with avascular bisphosphonate-related jaw osteonecrosis or in those who simply received pyrophosphate analogous when proper treatment with ozone therapy has been done.

Objective Oral surgery is compounded by safe and well-known techniques and presents a low rate of complications. When the superior alveolar ridge is approached, surgery may result in oroantral fistula or tooth or implant dislocation in maxillary sinus. Those conditions lead to development of the maxillary sinusitis that, if underestimated, may evolve in orbital cellulitis and cerebritis or cerebral abscess. Our work aimed to compare the surgical techniques suitable for treatment of those complications and define the better surgical strategy. Methods Between 2005 and 2010, 55 patients, presenting with displaced or migrated oral implants in the paranasal sinuses, with oroantral communication or with paranasal sinusitis of odontoiatrogenic origin, were visited and referred for treatment in the Maxillofacial Surgery Department of the University of Rome “La Sapienza.” Surgical treatment consists of one of the following procedures: functional endoscopic sinus surgery (FESS); intraoral approach to the sinus with Caldwell-Luc technique; and oroantral fistula closure with a local flap, alone or combined with FESS. Results The study group consisted of 55 patients: 28 female and 27 male patients aged 43 to 78 years (mean, 60 years). All had undergone oral surgery before our first visit: 17 patients had a prosthetic implant surgery (3 lateral-approach sinus augmentation and 15 implant placement). Seventeen patients had tooth extractions, 7 did root canal treatments, and 14 had sinus maxillary augmentation. Conclusions Functional endoscopic sinus surgery has slowly taken the place of the Caldwell-Luc technique in treating odontogenic maxillary sinusitis. Advantages of FESS are the less invasivity, the preservation of sinus anatomy and physiology, the reduction of recovery time, and oral rehabilitation without loosening efficacy compared with the previous transoral approach.

Objective: Fascia lata (FL) is a worldwide adopted source of autologous grafts. In our Department, the endoscopic endonasal transphenoidal surgery (EETS) has been performed regularly for anterior and middle cranial fossa lesions, and FL graft has commonly been a practical resource in repairing tissue defects after EETS. Enough, we used routinely harvesting FL to restore symmetry in facial palsy. To our known, this is the biggest case series about FL harvesting to repare tissue defects after EET. The purpose of our study was to evaluate our experience with the harvesting of FL, in particularly the donor site morbidity. Study design: This is a prospective study case series, which evaluated by questionnaire the morbidity of FL donr site. Methods: The details of 44 patients were analyzed from 2011 to 2016. Thirty-eight patients needed cranial base reconstruction and 6 patients needed facial reanimation. Results: Adequate length of FL was harvested in all our patients. There were no intraoperative complications. We did not use drain in any case. We analyzed 18 women (40%) and 26 men (59.9%). The estimated median age at presentation was 51.53. Conclusion: For little FL's gap, diameter until 3 × 6 cm, it's possible to suture FL's margin with Nylon, but for bigger gap it's necessary to reconstruct with allograft to avoid muscle bulge or compartmental syndrome.