Use of Platelet-Rich Plasma in the Management of Oral Biphosphonate-Associated Osteonecrosis of the Jaw: A Report of 2 Cases

Abstract

Bisphosphonates (BP) are nonhormonal medications used in the treatment of various bone malignancies and metabolic conditions. Since 2003, there have appeared a significant and growing number of articles in the worldwide medical and dental literature describing the complication of an osteonecrosis of the jaws associated with the intravenous and, most recently, the oral form of BP medication that has been refractory to any definitive form of treatment. The authors have successfully managed 2 patients taking the oral form of BP with adjunctive treatment using platelet-rich plasma (PRP), and in one case with hyperbaric oxygen (HBO). We were able to obtain complete remission in each case, which is defined as resolution of pain and complete closure of exposed bone in the jaws. The purpose of this report is to describe a treatment protocol and the rationale for using PRP and HBO to obtain complete remission of this new pathologic condition.

A Report on a 7-year Follow up of the Surgical Management with PRGF®- ENDORET® of Oncologic Patients Affected by Intravenous Bisphosphonate Related Osteonecrosis of the Jaw

“…In 2007, Lee et al have proposed and successfully managed 2 BRONJ using platelet-enriched preparations like platelet rich plasma (PRP ® ) [28].…”

Intraoperative detection of viable bone with fluorescence imaging using Visually Enhanced Lesion Scope in patients with bisphosphonate-related osteonecrosis of the jaw: clinical and pathological evaluation

“…For successful treatment during early stages of BRONJ, an early diagnosis and timely initiation of therapy are of crucial importance. Currently, case reports describe the use of other non-surgical treatment strategies, such as platelet-rich plasma [13], low-level laser irradiation [14], and parathyroid hormone [15]. It is also not clear whether the surgical approach is better than the conservative approach for the treatment of BRONJ.…”

The Treatment of Intravenous Bisphosphonates Induced Osteonecrosis of the Mandible: Case Report

“…[29][30][31] Lee ve ark., sundukları 2 vaka bildiriminde de platelet Rich Plasma ve hiperbarik oksijen tedavisi ile remisyonda tamamlanma gözlendiğini belirtmiştir. 32 Magopoulos ve ark., antibiyotik, cerrahi ve hiperbarik oksijen tedavisi ile 4 olguda tam bir iyileşme meydana geldiğini rapor etmiştir. 33 Bununla birlikte, Bedogni ve ark., preoperatif antibiyotik uygulaması ve postoperatif hiperbarik oksijen tedavisi sonucu bifosfonat kullanımı sonrası osteonekroz gelişimi olan hastalarda başarılı sonuçlar elde etmişlerdir.…”