title: Surgical treatment of osteonecrosis of the jaw with the use of platelet-rich fibrin: a prospective study of 15 patients.
abstract: The objective of this study was to evaluate the outcome of the surgical treatment of osteonecrosis of the jaw (ONJ) with the additional use of autologous membranes of platelet-rich fibrin (PRF). The study population consisted of 15 patients with ONJ lesions in the maxilla (n=3), mandible (n=11), or both (n=1). Eight patients had malignant disease and were treated with high-dose anti-resorptive medication; seven were treated with low-dose anti-resorptive drugs for osteoporosis. Thirteen patients had grade 2 ONJ lesions and two had grade 3 lesions. The following standardized surgical technique was applied: resection of necrotic bone, mobilization of mucoperiosteal flaps, and multiple layer coverage of bone with PRF membranes. At follow-up 7-20 months after surgery, complete mucosal healing and an absence of symptoms were found in 14 of the 15 patients (93%). The patient with persistent bone exposure had a grade 3 ONJ lesion before surgery. This study suggests that the use of PRF membranes in the surgical treatment of grade 2 ONJ may be a contributing factor to a successful outcome.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Aarhus University Hospital and Section of Maxillofacial Surgery and Oral Pathology, Aarhus University, Aarhus, Denmark. Electronic address: svenoe@rm.dk.
authors.forename: S E
authors.initials: SE
authors.lastname: Nørholt
authors.affiliation: Department of Oral and Maxillofacial Surgery, Aarhus University Hospital and Section of Maxillofacial Surgery and Oral Pathology, Aarhus University, Aarhus, Denmark.
authors.forename: J
authors.initials: J
authors.lastname: Hartlev
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D059266:Bisphosphonate-Associated Osteonecrosis of the Jaw / Q000601:surgery*; D050071:Bone Density Conservation Agents / Q000009:adverse effects; D004164:Diphosphonates / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000188:drug therapy; D000073183:Platelet-Rich Fibrin; D011446:Prospective Studies
chemical_list: D000900:Anti-Bacterial Agents; D050071:Bone Density Conservation Agents; D004164:Diphosphonates
keywords: Denosumab; anti-resorptive drugs; bisphosphonate-related osteonecrosis of the jaw; membranes; platelet concentrates; platelet-rich fibrin