title: Does the Addition of Bone Morphogenetic Protein 2 to Platelet-Rich Fibrin Improve Healing After Treatment for Medication-Related Osteonecrosis of the Jaw?
abstract: OBJECTIVE
  To investigate the effect of the addition of bone morphogenetic protein 2 (BMP-2) to leukocyte-rich and platelet-rich fibrin (L-PRF) on the treatment of medication-related osteonecrosis of the jaws (MRONJ), this study compared the healing outcome of combined use of BMP-2 and L-PRF with single use of L-PRF.
  
  
  METHODS
  Of 55 patients who were diagnosed with MRONJ, 25 were treated with L-PRF alone and 30 were treated with L-PRF and recombinant human BMP-2. For each patient, surgical sites were evaluated postoperatively at 4 and 16 weeks. Associations between the treatment method and the resolution of MRONJ were analyzed with the adjustment of patient-specific factors that may influence the treatment outcome.
  
  
  RESULTS
  At 4 and 16 weeks postoperatively, patients with MRONJ who were treated with both L-PRF and BMP-2 showed favorable outcomes with complete resolution of the lesions, which was statistically significant compared with that of the therapy using L-PRF alone (P = .028). Therefore, the additional use of BMP-2 considerably improved MRONJ healing. Among patient-specific factors, the existence of a bacterial colony in the biopsy specimen was a significant factor that negatively affected disease resolution (P = .017).
  
  
  CONCLUSIONS
  The combined use of BMP-2 and L-PRF leads to the early resolution of MRONJ; thus patients who need to continue antiresorptive therapy may benefit from the combined regimen.
authors.affiliation: Clinical Assistant Professor, Department of Oral and Maxillofacial Surgery, Ewha Womans University, Seoul, Republic of Korea.
authors.forename: Jung-Hyun
authors.initials: JH
authors.lastname: Park
authors.affiliation: Clinical Assistant Professor, Department of Oral and Maxillofacial Surgery, Ewha Womans University, Seoul, Republic of Korea.
authors.forename: Jin-Woo
authors.initials: JW
authors.lastname: Kim
authors.affiliation: Professor, Department of Oral and Maxillofacial Surgery, Ewha Womans University, Seoul, Republic of Korea. Electronic address: oralsurgeonsj@gmail.com.
authors.forename: Sun-Jong
authors.initials: SJ
authors.lastname: Kim
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019072:Antibiotic Prophylaxis; D059266:Bisphosphonate-Associated Osteonecrosis of the Jaw / Q000188:drug therapy* / Q000601:surgery*; D001792:Blood Platelets; D055396:Bone Morphogenetic Protein 2 / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D003777:Dental Prophylaxis; D005260:Female; D005337:Fibrin / Q000627:therapeutic use*; D006801:Humans; D007962:Leukocytes; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome; D014945:Wound Healing / Q000187:drug effects*
chemical_list: D055396:Bone Morphogenetic Protein 2; D005337:Fibrin