A Clinical and Histological Study about the Socket Preservation in a Patient under Oral Bisphosphonates Treatment: A Case Report

Falco, Alessandra; Bataccia, Francesco; Orgeas, Lorenzo Vittorini; Perfetti, Federico; Basile, Mariangela; Pietro, Roberta Di

doi:10.3390/biology10040262

Cited by 1 publication

(2 citation statements)

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“…Multiple studies have evaluated bone healing, particularly in MRONJ. The main imaging tools used for both diagnosis and follow-up are orthopantomography and CBCT (Falco et al, 2021;Bouland et al, 2021;Canakci et al, 2021;Ragazzo et al, 2021). Here, we report the use of PET-CT to follow bone repair in one patient who was undergoing this exam for the monitoring of her cancer.…”

Section: Discussionmentioning

confidence: 99%

“…The radiological findings of the two remaining cases were not provided. Histology has been used to evaluate postextractive alveolus healing following the procedure for socket preservation in a patient receiving oral Bisphosphonates for more than 6 years (Falco et al, 2021). However, like the American Association of Oral and Maxillofacial Surgeons (AAOMS) recommendations (Ruggiero et al, 2014), we agree that an osseous or mucosal biopsy to follow the wound healing process in MRONJ patients is too invasive and could impact the healing process or reinfect the treated lesions.…”

Section: Discussionmentioning

confidence: 99%

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Tips and Tricks and Clinical Outcome of Cryopreserved Human Amniotic Membrane Application for the Management of Medication-Related Osteonecrosis of the Jaw (MRONJ): A Pilot Study

Odet

Meyer

Gaudet

et al. 2022

Front. Bioeng. Biotechnol.

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Medication-related osteonecrosis of the jaw (MRONJ) is a complication of certain pharmacological treatments such as bisphosphonates, denosumab, and angiogenesis inhibitors. There are currently no guidelines on its management, particularly in advanced stages. The human amniotic membrane (hAM) has low immunogenicity and exerts anti-inflammatory, antifibrotic, antimicrobial, antiviral, and analgesic effects. It is a source of stem cells and growth factors promoting tissue regeneration. hAM acts as an anatomical barrier with suitable mechanical properties (permeability, stability, elasticity, flexibility, and resorbability) to prevent the proliferation of fibrous tissue and promote early neovascularization at the surgical site. In oral surgery, hAM stimulates healing and facilitates the proliferation and differentiation of epithelial cells in the oral mucosa and therefore its regeneration. We proposed using cryopreserved hAM to eight patients suffering from cancer (11 lesions) with stage 2–3 MRONJ on a compassionate use basis. A collagen sponge was added in some cases to facilitate hAM grafting. One or three hAMs were applied and one patient had a reapplication. Three patients had complete closure of the surgical site with proper epithelialization at 2 weeks, and two of them maintained it until the last follow-up. At 1 week after surgery, three patients had partial wound dehiscence with partial healing 3 months later and two patients had complete wound dehiscence. hAM reapplication led to complete healing. All patients remained asymptomatic with excellent immediate significant pain relief, no infections, and a truly positive impact on the patients’ quality of life. No adverse events occurred. At 6 months of follow-up, 80% of lesions had complete or partial wound healing (30 and 50%, respectively), while 62.5% of patients were in stage 3. Radiological evaluations found that 85.7% of patients had stable bone lesions (n = 5) or new bone formation (n = 1). One patient had a worsening MRONJ but remained asymptomatic. One patient did not attend his follow-up radiological examination. For the first time, this prospective pilot study extensively illustrates both the handling and surgical application of hAM in MRONJ, its possible association with a collagen sponge scaffold, its outcome at the site, the application of multiple hAM patches at the same time, and its reapplication.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%