Prof Mario Estavillo Esquillo

DMD

He was the PRESIDENT of the Asian Association of Oral and Maxillofacial Surgeons in 2014-2016. He graduated in 1982 from the Manila Central University, College of Dentistry and was awarded the Best Clinician in Oral Surgery. He underwent EXTERNSHIP TRAINING in Oral Surgery at the University of the Philippine, Philippine General Hospital in 1983. He undertook POST GRADUATE in Oral and Maxillofacial Surgery, Tri-Service General Hospital, Taipei, Taiwan, ROC, 1989-1991 and at the 2nd Department of Oral and Maxillofacial Surgery, Aichi-Gakuin, School of Dentistry, Nagoya, Japan, 1997. He was the president of the Philippine Dental Association (2005-2006) and the president of the Manila Dental Society in 2002-2003. He is the founding chairman of the Philippine College of oral & Maxilofacial and the ASSOCIATE PROFESSOR of the Manila Central University, College of Dentistry .

Role of Antibiotic Beads in Oral and Maxillofacial Surgery

OBJECTIVE: This aims to present a good alternative treatment of chronic and classical osteomyelitis, osteoradionecrosis, and bisphosphonate-related osteonecrosis of the jaw (BRONJ) in the form of polymethyl methacrylate beads impregnated with antibiotics. METHODS: Cases of classical osteomyelitis, osteomyelitis resulting from facial implant rejection, osteoradionecrosis as well as bisphosphonate-related osteonecrosis of the jaw (BRONJ), that were treated in our department with placement of polymethyl methacrylate impregnated with antibiotics are presented. Treatment consists of thorough debridement and curettage to remove infected and necrotic tissue, placement of antibiotic beads, and primary closure of the wound. Removal of the antibiotic beads is then performed after six weeks. The advantage to this approach of drug delivery is that very high local concentrations of an antibiotic can be obtained with minimal systemic levels. Other advantages include: systemic adverse reactions are less likely to occur, beads can fill a dead space created by curettage and sequestrectomy, and because the surgical wound is closed, post-operative management is straightforward, and there is no restriction in activities of daily living. Primary disadvantage is the need for another surgery to remove the beads. RESULTS: Results have proven to be favorable and good long term success were observed in all the cases performed. Symptoms disappeared as soon as after the surgery. Early bone formation was evident on panoramic radiograph as early as 6 weeks after removal of the beads. CONCLUSION: Placement of antibiotic beads is a good alternative in difficult chronic and refractory cases where parenteral and oral medications have failed.