Adjuvant therapies in the management of medication-related osteonecrosis of the jaws: Systematic review.

Autor: de Souza Tolentino E; Department of Dentistry, State University of Maringá, Maringá, Brazil., de Castro TF; Oral Oncology Center, São Paulo State University (Unesp), School of Dentistry, Araçatuba, São Paulo, Brazil., Michellon FC; Department of Dentistry, State University of Maringá, Maringá, Brazil., Passoni ACC; Department of Dentistry, State University of Maringá, Maringá, Brazil., Ortega LJA; Department of Dentistry, State University of Maringá, Maringá, Brazil., Iwaki LCV; Department of Dentistry, State University of Maringá, Maringá, Brazil., da Silva MC; Department of Dentistry, State University of Maringá, Maringá, Brazil.
Jazyk: angličtina
Zdroj: Head & neck [Head Neck] 2019 Dec; Vol. 41 (12), pp. 4209-4228. Date of Electronic Publication: 2019 Sep 10.
DOI: 10.1002/hed.25944
Abstrakt: Background: We investigated the efficacy of hyperbaric oxygen (HBO), low-intensity laser (LIL), and platelet-rich plasma (PRP) in the management of medication-related osteonecrosis of the jaws (MRONJ).
Methods: A literature search was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Two examiners independently assessed eligibility and risk of bias and extracted data.
Results: There was improvement in 75.6% of the 41 patients submitted to HBO, with positive effects on pain relief and decreased size and number of lesions at a faster rate, with better effects when the drug was discontinued. For LIL, 158 (64.2%) of the 246 patients/sites improved the symptoms and 98 (39.8%) healed completely. Fourteen (17.3%) of the 81 patients treated with PRP significantly improved the symptoms and 65 (80.2%) completely healed.
Conclusions: These therapies served as safe and effective adjuvant modalities for MRONJ treatment. The lack of randomized clinical trials evidences the need for more high-quality investigations on the subject.
(© 2019 Wiley Periodicals, Inc.)
Databáze: MEDLINE
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