The use of Platelet-rich Fibrin in the management of medication-related osteonecrosis of the jaw: A case series

Mourão, Carlos Fernando de Almeida Barros; Calasans-Maia, Mônica Diuana; Fabbro, Massimo Del; Vieira, Filipe; Mello-Machado, Rafael Coutinho; Capella, Raphaela; Miron, Richard J.; Alves, Gutemberg Gomes

doi:10.1016/j.jormas.2019.02.011

Cited by 34 publications

(72 citation statements)

References 24 publications

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“…One patient with persistent exposed bone had renal cancer and was treated with high-dose antiresorptive medication 24 . Mouro et al published a study of 11 patients with MRONJ treated with resection and PRF application and observed complete healing in 100%, but in this study only patients with osteoporosis were included 25 . This ar-one year after treatment VAS 0, stage 1, size of dehiscence 25x10 mm.…”

Section: Resultsmentioning

confidence: 97%

The use of platelet-rich fibrin in the surgical treatment of medication-related osteonecrosis of the jaw: 40 patients prospective study

Zelinka¹,

Blahák²,

Peřina³

et al. 2021

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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Objectives. Medication-related osteonecrosis of the jaw (MRONJ) is defined as exposed bone in the maxillofacial region persisting for more than eight weeks in patients who are or were treated with antire sorptive or antiangiogenic agents and had no radiation therapy to the craniofacial region or obvious metastatic disease of the jaws. It is a recognised side effect of antiresorptive or antiangiogenic medication. To date, there is no specific gold standard treatment for MRONJ cases. The aim of this study was to evaluate the successful rate of surgical treatment with adjuvant local application of platelet rich fibrin. Methods. 40 patients treated with necrotic bone resection and adjuvant local application of platelet-rich fibrin (PRF) were included. Treatment outcomes were evaluated after 12 months. Results. The outcome of surgical treatment was successful in 34 of all 40 patients (85%), in 12 months follow-up. If we evaluate only cases where removal of all necrotic bone was possible the success rate was increased to 94%. A significant association between size of necrotic bone and treatment response was found (P=0.014, Wilcoxon rank sum test with continuity correction). Conclusions. Surgical treatment of MRONJ with adjuvant local PRF application proved to be very effective and safe, especially in early stages when all necrotic bone can be easily removed.

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Section: Resultsmentioning

confidence: 97%

The use of platelet-rich fibrin in the surgical treatment of medication-related osteonecrosis of the jaw: 40 patients prospective study

Zelinka¹,

Blahák²,

Peřina³

et al. 2021

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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“…The commonest diagnoses relating to BRONJ were: breast cancer, in 60 individuals 9,10,12,16,17,19,21 (46.87%); osteoporosis, 10,[17][18][19][23][24][25][26] in 25 (19.53%); multiple myeloma, 5,9,16,17,20 in 16 (12.50%); and prostate cancer, 9,10,16,18,19 in 16 (12.50%) ( Table 1). 4,5,9,10,12,[16][17][18][19][20][21][23][24][25][26] The types of BPs most related to BRONJ were: zoledronic acid 9,10,12,[16][17][18][19][20][21]26...…”

Section: Resultsmentioning

confidence: 99%

“…The duration of BP use until a manifestation of BRONJ ranged from 5 to 15 months, with a mean of 45.8 ± 39.7 months. 4,5,9,[16][17][18][19][20][21][22][23][24][25][26] Regarding the location of the BRONJ, the mandible was the most affected by BRONJ, 4,9,10,[16][17][18][19][20]25 in 70 cases (54.68%), followed by the maxilla 9,10,12,[16][17][18][19]21,[23][24][25][26] manifestations were in both jaws, 16,17,19 the palatine torus 10 and the mylohyoid region 17 ( Table 2). 4,5,9,10,12,[16][17][18][19][20]…”

Section: Resultsmentioning

confidence: 99%

“…4,5,9,10,12,[16][17][18][19][20][21][23][24][25][26] The main diagnostic criterion was clinical evaluation of bone exposure, 4,5,9,[16][17][18][19][20][21][22][23][24][25][26] which was found to be present in 100% of the cases. The most common complementary examinations were panoramic radiographs, 4,5,9,10,[16][17][18][19][20]23,25 in 114 cases (89.06%); and conebean computed tomography, 4,5,12,16,19,21,[24][25][26] in 52 cases (40.62%).…”

Section: Resultsmentioning

confidence: 99%

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Clinical profile of individuals with bisphosphonate-related osteonecrosis of the jaw: an integrative review

et al. 2020

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“…A strong correlation between the use of these drugs and the risk of osteonecrosis of the jaws has been well documented in the literature, especially after a local trauma, mainly as tooth extraction [4,5]. This complication is characterized by an intraoral persistent area of bone exposure and/or signs of infection for a minimum period of 8 weeks that occurs in patients who are under current or previous treatment with BPs or other anti-resorbing drugs, without a clinical history of the head/neck radiotherapy [4,6,7].…”

Section: Introductionmentioning

confidence: 99%

Use of Platelet Rich Fibrin (PRF)-Based Autologous Membranes for Tooth Extraction in Patients under Bisphosphonate Therapy: A Case Report

et al. 2019

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Tooth extraction in patients treated with bisphosphonates (BPs) for osteoporosis or cancer exposes the patient to the risk of osteonecrosis of the jaw. An autologous membrane using platelet-rich fibrin (PRF) is an innovative technique to promote wound healing, which allows obtaining a hermetic closure of the post-extractive surgical site without the need of mucoperiosteal flaps or periosteal releasing incisions. Here, we report the case of a 70-year-old woman, in therapy with alendronate for 12 years, requiring the upper right premolar extraction because of a crown fracture. After the tooth extraction performed under antiseptic and antibiotic coverage, the PRF autologous membrane was placed on the surgical wound to close completely the post-extraction site. Follow-up visits were carried out after one, two, four weeks and two months from the intervention. The complete re-epithelization of the wound was observed without signs of infection. The use of PRF for the closure of post-extraction sockets in patients taking BPs appears to be a promising alternative to the more invasive surgical procedures. Future clinical trials will be pivotal in elucidating the effectiveness of PRF to prevent BP-related osteonecrosis after tooth extraction.

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The use of Platelet-rich Fibrin in the management of medication-related osteonecrosis of the jaw: A case series

Cited by 34 publications

References 24 publications

The use of platelet-rich fibrin in the surgical treatment of medication-related osteonecrosis of the jaw: 40 patients prospective study

The use of platelet-rich fibrin in the surgical treatment of medication-related osteonecrosis of the jaw: 40 patients prospective study

Clinical profile of individuals with bisphosphonate-related osteonecrosis of the jaw: an integrative review

Use of Platelet Rich Fibrin (PRF)-Based Autologous Membranes for Tooth Extraction in Patients under Bisphosphonate Therapy: A Case Report

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