Everyday Oral Surgery

Dr. Thomas Schlieve: Changing the way you think about MRONJ


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They don’t call him “Triple D” for nothing. Dr. Thomas Shlieve is an expert in the field of osteonecrosis and has earned his nickname as the Deadbone Doctor of Dallas. Yet the reality is that osteonecrosis is a serious condition that can greatly impact the quality of life of a patient suffering from it. Thomas knows this all too well, which is why he is hugely passionate about helping patients with dead jawbone. In this episode, we explore a number of different types of osteonecrosis, how medication can affect the healing of jawbones and what methods of solution are available to doctors and sufferers. Thomas shares what to look out for and how you should discuss your findings with the patient. He touches on explanations of drugs and their uses as well as when surgery becomes an absolute necessity. Given the many nuances of dead jawbone, Thomas takes time to detail how different patients can experience the condition. Following this, Thomas shares additional information on his approach to assisting patients who are on bisphosphonate medications and talks about how literature and white papers contrast with reality. In the latter stages of the show, Thomas talks about what options are available to patients who simply won’t heal and which surgical approaches he might use as intervention. To conclude, Thomas shares parting thoughts on when surgery is and isn’t required, as well as the cautions one should take with dead jawbone. 


Key Points From This Episode:

  • Introducing today’s guest, Dr. Thomas Shlieve.
  • Why Thomas’ nickname is “Triple D”. 
  • Hear in simple terms, what MRONJ is.
  • Thomas lists some of the high-risk drugs that can cause MRONJ.
  • What sort of things to look out for and what you should be discussing with your patient.
  • How different patients can be affected by dead jawbones.
  • What Thomas does differently for patients who are on bisphosphonate medications.
  • What options you have when your patient is not healing.
  • Tips for moving toward a surgical approach.
  • How Thomas makes his incisions on patients.
  • Thomas shares the intricacies involved in primary closures.
  • Hear Thomas’ parting thoughts.


Links Mentioned in Today’s Episode:

Dr. Thomas Shlieve

Dr. Thomas Shlieve on LinkedIn

Complications in Neck Dissection on Amazon

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Everyday Oral SurgeryBy Grant Stucki - oral and maxillofacial surgeon

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