Use of platelet- and leukocyte-rich fibrin (l-prf) in bisphosphonate-related osteonecrosis of the jaw (bronj) in rats - split-mouth study

Abstract

This study aimed to clinically evaluate the effect of platelet- and leukocyte-rich fibrin (L-PRF) membranes in preventing bisphosphonate-related osteonecrosis of the jaw (BRONJ) in rats. In this study, twelve Wistar rats (six males and six females) were used. A split-mouth study was performed; the right-side was used as treatment, with treatment of platelet- and leukocyte-rich fibrin membranes (L-PRF group, LPRFG), and the left-side received no intervention as control (control group, CG). The rats received intravenous Zolendronate (Zol) (80 ug/kg/week) injections during nine weeks to induce the BRONJ. The surgical extractions were divided into two stages: in the eighth week of Zol injections, the first lower molars on both sides were removed followed by bone decorticalization. In the ninth week of Zol injections, extractions of the second lower molars were performed on both sides, followed by bone decorticalization. L-PRF membranes were made of 1 ml of blood by cardiac puncture. The following clinical variables were analyzed: presence of bone exposure, inflammation (edema, erythema), suppuration, bony sequestrum and epithelialization of the alveoli. In addition, the mesiodistal (MD) and buccolingual (BL) dimensions of bone exposure were obtained using a millimeter probe. Statistical analysis was performed using Fisher's exact test, with a significance level of 0.05. There were no significant differences between the sides regarding the presence of bone exposure, inflammation, suppuration, bony sequestrum and epithelialization of the alveoli (p > 0.05). However, lower bone exposure was observed in the MD (p = 0.002) and BL (p = 0.03) dimensions in the LPRFG. Thus, the use of L-PRF membrane decreased bone exposure contributing to the alveoli healing of BRONJ in rats.