Promising results of surgical management of advanced medication related osteonecrosis of the jaws using adjunctive leukocyte and platelet rich fibrin


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ÖZALP Ö., Yildirimyan N., Ozturk C., Kocabalkan B., ŞİMŞEK KAYA G., SİNDEL A., ...Daha Fazla

BMC ORAL HEALTH, cilt.21, sa.1, 2021 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 21 Sayı: 1
  • Basım Tarihi: 2021
  • Doi Numarası: 10.1186/s12903-021-01965-7
  • Dergi Adı: BMC ORAL HEALTH
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CAB Abstracts, CINAHL, EMBASE, MEDLINE, Directory of Open Access Journals
  • Anahtar Kelimeler: Medication-related osteonecrosis of the jaw, Osteonecrosis, Surgical treatment, Adjunctive therapy, Leukocyte and platelet rich fibrin, Platelet concentrates, BISPHOSPHONATE-RELATED OSTEONECROSIS, BONE MORPHOGENETIC PROTEIN-2, MAXILLOFACIAL SURGERY, CURRENT KNOWLEDGE, CANCER-PATIENTS, PLASMA PRP, TERIPARATIDE, DIAGNOSIS, PERSPECTIVES, PREVENTION
  • Akdeniz Üniversitesi Adresli: Evet

Özet

Background Leukocyte- and platelet-rich fibrin (L-PRF) is an autologous matrix scaffold which regulates inflammation by stimulating cytokines and growth factors that are involved in the immune response. L-PRF is suggested as a viable adjunctive method to surgical interventions due to its advantages on tissue healing. This study aims to retrospectively evaluate the adjunctive role of L-PRF in surgically treated medication-related osteonecrosis of the jaws (MRONJ) patients. Methods Between January 2012 and December 2020, patients with AAOMS stage II and III MRONJ lesions, who were treated surgically with adjunctive use of L-PRF in the authors' institution were enrolled. Surgical interventions consisted of either marginal resection or sequestrectomy with peripheral ostectomy (SPO) or curettage and L-PRF application. Medical records of these patients were retrospectively reviewed and healing was assessed according to certain parameters including mucosal closure and presence of infection, exposed bone, fistula or radiologic markers of disease progression for a minimum of 12 months. Results Thirteen patients (7 women and 6 men) with an average age of 72.4 years (+/- 10.61, range 54-84) were included in the study, nine of whom had AAOMS stage III and four stage II MRONJ. Three patients had a marginal resection, nine patients had sequestrectomy with peripheral ostectomy (SPO) and one patient underwent a curettage procedure. All marginal resection and six SPO patients showed complete healing while four patients, who had SPO or curettage experienced incomplete healing. Mean follow up was 20.1 +/- 18.29 months. Conclusion The use of L-PRF may be a favorable adjunctive option in the treatment of MRONJ owing to its favorable effects on tissue repair, ease of application, minimally invasive and cost-effective character and autogenous nature. Trial registration Retrospectively registered.