Treatment of Refractory Medicine Related Osteonecrosis of Jaw With Piezosurgical Debridement and Autologous Platelet Rich Fibrin: Feasibility Study.

Autor:	Gurav S; Department of Dental and Prosthetic Surgery, lata memorial Hospital, Mumbai, India. Homi Bhabha National Institute (HBNI) Mumbai, India.; Homi Bhabha National Institute (HBNI), Mumbai, India., Dholam KP; Department of Dental and Prosthetic Surgery, lata memorial Hospital, Mumbai, India. Homi Bhabha National Institute (HBNI) Mumbai, India.; Homi Bhabha National Institute (HBNI), Mumbai, India., Singh GP; Homi Bhabha National Institute (HBNI), Mumbai, India.; Advanced Centre of Treatment, Research and Education in Cancer (ACTREC), Navi Mumbai. India. Homi Bhabha National Institute (HBNI), Mumbai, India.
Jazyk:	angličtina
Zdroj:	The Journal of craniofacial surgery [J Craniofac Surg] 2022 May 01; Vol. 33 (3), pp. e226-e230. Date of Electronic Publication: 2021 Jul 23.
DOI:	10.1097/SCS.0000000000007981
Abstrakt:	Abstract: Medicine related osteonecrosis of jaw (MRONJ) is incidental in patients receiving certain bone modifying agents in oncology. These lesions may not respond to conservative management and aggravate. Autologous platelet derivatives contain bone growth factors, which help in bone regeneration. The aim of this pilot study is to develop protocol for treatment of refractory MRONJ with pizosurgical debridement and advanced platelet rich fibrin.In this feasibility study, refractory MRONJ lesions were treated by piezosurgical debridement and insertion of autologous advanced platelet rich fibrin in 15 patients. One patient had 2 lesion sites, so in all 16 MRONJ sites were treated. These patients were evaluated at the end of 1 month and 4 months for healing of MRONJ lesion. Statistical analysis was done by using Fisher test for response assessment in relation to variable. Eight lesions (50%) showed complete healing at the end of 1 month. At the end of 4 months 13 lesions (81.50%) were completely healed, 2 lesions (12.5%) were downgrades, and 1 lesion (6.25%) did not respond to treatment. Number of doses of bone modifying agent was only factor found associated with nonhealing of MRONJ when treated with this protocol.In this pilot study, feasibility of use of piezosurgical debridement and platelet rich fibrin was evaluated. The results of the study suggest complete healing can be achieved with this treatment protocol. Further research with increased sample size is warranted to determine optimum use of autologous platelet concentrates in treatment of MRONJ. Competing Interests: The authors report no conflicts of interest. (Copyright © 2021 by Mutaz B. Habal, MD.)
Databáze:	MEDLINE
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