Surgery Combined with LPRF in Denosumab Osteonecrosis of the Jaw: Case Report

Maluf, Gustavo; Pinho, Milena Correia De; Cunha, Sandra Ribeiro; Santos, Paulo Sérgio da Silva; Fregnani, Eduardo Rodrigues

doi:10.1590/0103-6440201600662

Cited by 27 publications

(39 citation statements)

References 32 publications

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“…The present literature review had several limitations, especially a reduced number of randomized studies [49][50][51] . Amongst other limitations, 50% of the studies had small samples, consisting of one to two patients, two studies were comparative and two studies had a series of control patients 52,53 .…”

Section: Discussionmentioning

confidence: 99%

Fibrin Rich in Leukocytes and Platelets L-PRF and Bisphosphonate-Induced Osteonecrosis: We Need to Advertise Now

Faria¹,

Cabral²,

Castro³

et al. 2019

IJTSRD

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The American Association of Oral and Maxillofacial Surgeons (AAOMS) reported in 2004 a new pathology that causes osteonecrosis in the Maxillomandibular complex. The condition was named Bisphosphonate-related osteonecrosis of the jaw (BRONJ), and later renamed by medication related to jaw osteonecrosis due to the appearance of severe alveolar bone loss in the Maxillomandibular complex resulting from the use of different drugs other than Bisphosphonates. Odontology, especially oral surgery, a field concerned with new biotechnologies, has been introducing innovations in tissue engineering. Oro-maxillofacial reconstruction is of great interest to current oral and maxillofacial surgeons, as part of the search for strategies in bioengineering and biomaterials, a major promoter of bio-dental research in our times. In order to verify the scientific evidences to analyse the effectiveness of leukocyte and platelet rich fibrin (L-PRF) on bone neoformation in Maxillomandibular complex's surgical procedures, a search for qualified articles was conducted in the Medline (PubMed), Embase and Cochrane Central Register of Controlled Trials databases. The works analysed were published from 2013 to 2018. This review concludes that the use of platelet rich fibrin (L-PRF) is significant in the complete healing of the lesion in short postoperative periods and in the resolution of the treatments, reducing the need for postoperative re-interventions, resulting in lower morbidity for the patients.

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Section: Discussionmentioning

confidence: 99%

Fibrin Rich in Leukocytes and Platelets L-PRF and Bisphosphonate-Induced Osteonecrosis: We Need to Advertise Now

Faria¹,

Cabral²,

Castro³

et al. 2019

IJTSRD

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“…Keywords: Osteonecrosis Associated with Bisphosphonates, L-PRF, Jaw. 9 afirma em seu relato de caso que a associação entre intervenção cirúrgica e L-PRF não resultou em remissão completa no tratamento da osteonecrose dos maxilares, mas que combinação de cirurgia e L-PRF pode ser um tratamento promissor.…”

Section: Introductionunclassified

“…OMN é um possível efeito adverso da terapêutica com drogas anti-reabsortivas indicadas principalmente para tratamento de osteoporose, doença de Paget, mieloma múltiplo ou neoplasias ósseas 3,4. A fisiopatologia da OMN ainda não foi completamente elucidada, mas entre as hipóteses mais aceitas estão a inibição da remodelação óssea, devido a ação deletéria direta sobre os osteoclastos, e a diminuição da vascularização e consequentemente hipóxia e necrose tecidual 2.…”

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Considerações clinicas sobre o uso do L-PRF na terapêutica de osteonecrose medicamentosa dos maxilares: relato de caso

Viana

Carvalho

Fialho

et al. 2019

BJHR

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RESUMOIntrodução: A osteonecrose medicamentosa dos maxilares (ONM) é uma patologia que acomete com frequência os ossos da face, principalmente a mandíbula, devido à limitada vascularização e pouca maleabilidade óssea. Metodologia: Paciente compareceu ao Serviço de Cirurgia e Traumatologia Buco-Maxilo-Facial do Hospital do Oeste -Bahia, devido a dor e presença de secreção após o uso de prótese dentária inferior, relatando uso prévio de Alendronato de Sódio. Ao exame físico observou-se exposição óssea em região de corpo mandibular bilateral com presença de secreção purulenta. O exame imaginológico evidenciou áreas de sequestro ósseo em região de corpo mandibular bilateral, com limites definidos e envolvida por halo radiolúcido. Sob anestesia geral, foi realizada a remoção cirúrgica da lesão e inserção de membranas de L-PRF no leito cirúrgico. A peça cirúrgica foi coletada e enviada para exame anatomopatológico, confirmando diagnóstico clínico. Resultados: A paciente evoluiu sem queixas álgicas, com ausência de exposição óssea e remissão completa do quadro clínico inicial. Discussão: A intervenção cirúrgica é um tratamento invasivo, indicado em estágios avançados de OMN, e objetiva eliminar sequestros e regularizar margens ósseas, podendo resultar em um defeito na continuidade óssea com potencial de cura comprometido pela terapia previa, nesse contexto, o L-PRF colabora para o controle da infecção e age como barreira de proteção mecânica local. Conclusão: A associação entre intervenção cirúrgica e uso de L-PRF, se mostrou eficaz no tratamento da OMNs. Contudo, mais estudos acerca do uso do L-PRF são necessários para garantir a eficácia da terapêutica a longo prazo. Palavras-chaves:Osteonecrose Associada a Bifosfonatos, L-PRF, Mandíbula. ABSTRACTIntroduction: Medicinal osteonecrosis of the maxilla (ONM) is a pathology that frequently affects the bones of the face, especially the mandible, due to limited vascularity and poor bone malleability. Methodology: Patient attended the Service of Oral and Maxillofacial Surgery and Traumatology of the Hospital do Oeste -Bahia, due to pain and presence of secretion after the use of inferior dental prosthesis, reporting previous use of Alendronate of Sodium. Physical examination showed bone exposure in a region of bilateral mandibular body with purulent secretion. The imaging examination revealed areas of bone sequestration in a region of bilateral

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“…Since then, documented cases have been taking place in recent years considering the pathology as a major complication as a consequence of the use of this family of drugs (Fig. 1 ) ( 1 - 3 ).…”

Section: Introductionmentioning

confidence: 99%

“…Furthermore, this complication has been associated with the use of other drugs such as Denosumab, an antiresorptive drug of the monoclonal antibody family, used in the same way for the treatment of osteoporosis and for the metastatic bone disease ( 3 ). However, this drug has a different mechanism of action than BPs.…”

Section: Introductionmentioning

confidence: 99%

The role of Leucocyte-rich and platelet-rich fibrin (L-PRF) in the treatment of the medication-related osteonecrosis of the jaws (MRONJ)

et al. 2017

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BackgroundFor the treatment of the bisphosphonates and other drugs related osteonecrosis of the jaws, currently medication-related osteonecrosis of the jaws (MRONJ), have been established different conservative therapeutic approaches, avoiding surgery except in cases of extreme need. Given the controversy and lack of current consensus regarding MRONJ therapy in patients, new techniques have been developed among which the use of fibrin membranes rich in platelets and leukocytes (L-PRF). The objective of this review is to evaluate whether L-PRF treatment is really effective, as well as the results that can be achieved by this therapeutic alternative.Material and MethodsA review of the literature in the PubMed/Medline database of all those studies using L-PRF in the treatment of osteonecrosis using the keywords “Osteonecrosis”, “Jaws”, “L-PRF” and “ Leucocyte-rich platelet-rich fibrin “.ResultsThe use of L-PRF for the treatment of MRONJ is really effective, especially when it is performed with a simultaneous application of L-PRF and morphogenetic protein-2 (BMP-2), even in patients submitted for long periods of time to therapy with intravenous bisphosphonates. However, success will depend on several factors such as the previous existence of infection or the clinical stage in which the patient is.ConclusionsThe current literature demonstrates the effectiveness of the use of L-PRF in osteonecrosis, and it can be considered as a real alternative in the treatment of this entity. However, more clinical studies are needed to really assess this new therapy. Key words:Osteonecrosis, Jaws, L-PRF, Leucocyte-rich platelet-rich fibrin.

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Surgery Combined with LPRF in Denosumab Osteonecrosis of the Jaw: Case Report

Cited by 27 publications

References 32 publications

Fibrin Rich in Leukocytes and Platelets L-PRF and Bisphosphonate-Induced Osteonecrosis: We Need to Advertise Now

Fibrin Rich in Leukocytes and Platelets L-PRF and Bisphosphonate-Induced Osteonecrosis: We Need to Advertise Now

Considerações clinicas sobre o uso do L-PRF na terapêutica de osteonecrose medicamentosa dos maxilares: relato de caso

The role of Leucocyte-rich and platelet-rich fibrin (L-PRF) in the treatment of the medication-related osteonecrosis of the jaws (MRONJ)

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