title: Conservative treatment with plasma rich in growth factors-Endoret for osteoradionecrosis.
abstract: OBJECTIVE
  Osteoradionecrosis (ORN) is the worst long-term complication due to radiotherapy to the head and neck and is defined as an area of exposed necrotic oral bone, with failure to heal for at least 3 months. In most cases, ORN is associated with oral surgery procedures involving the jaw bone. The aim of this study was to evaluate the safety and effectiveness of a biological approach for ORN treatment.
  
  
  METHODS
  A series of 10 patients with ORN were treated by debridement of necrotic bone using an ultrasound device followed by application of plasma rich in growth factors (PGRF)-Endoret to improve and accelerate soft-tissue healing. Patients were followed clinically and radiographically up to 12 months. Pain was assessed in the first week postsurgery using a visual analogue scale (VAS). Maturation and quality of tissue healing was assessed using a modified healing index.
  
  
  RESULTS
  All cases were successfully treated. No intraoperative or postoperative complications occurred. Clinical and radiographic evaluations showed no signs of persistent infection or exposed bone up to 12 months of follow-up. The maturity and quality of the regenerated tissues was excellent, surgical wounds always achieving complete closure. VAS scores and trismus were very low in all patients, which did not take analgesics since the third day after surgery.
  
  
  CONCLUSIONS
  PRGF-Endoret is beneficial, as an adjunct to surgical treatment of osteoradionecrosis, for predictable enhancement of tissue vascularization and epithelialization in patients with a history of head and neck radiotherapy.
authors.affiliation: *SIOM Oral Surgery and Implantology Center, Turin †Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, IRCCS Istituto Ortopedico Galeazzi, Milan ‡Oral Surgery Unit, Dentistry Section, Department of Biomedical Sciences and Human Oncology, University of Turin, Turin §Department of Health Sciences "A. Avogadro", University of Eastern Piedmont, Novara, Italy.
authors.forename: Giorgia
authors.initials: G
authors.lastname: Gallesio
authors.forename: Massimo
authors.initials: M
authors.lastname: Del Fabbro
authors.forename: Renato
authors.initials: R
authors.lastname: Pol
authors.forename: Carmen
authors.initials: C
authors.lastname: Mortellaro
authors.forename: Marco
authors.initials: M
authors.lastname: Mozzati
mesh_terms: D000368:Aged; D003646:Debridement / Q000379:methods*; D005260:Female; D006801:Humans; D036341:Intercellular Signaling Peptides and Proteins / Q000494:pharmacology*; D008297:Male; D008875:Middle Aged; D010025:Osteoradionecrosis / Q000628:therapy*; D014945:Wound Healing
chemical_list: D036341:Intercellular Signaling Peptides and Proteins