Autologous platelet concentrates in extraction sockets for the prevention of osteoradionecrosis: a systematic review of controlled clinical trials

Serrano, Rafael Verardi; Gomes, Thiago Pallin; Silva, Felipe Medeiros da; Marques, Márcia Martins; Palma, Luiz Felipe

doi:10.1007/s10006-021-01030-1

Cited by 3 publications

(4 citation statements)

References 25 publications

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“…Few systematic reviews on this topic were published 37 , 38 . Del Fabbro et al 37 addressed the use of platelet concentrates in the treatment and prevention of osteonecrosis of the jaw associated with bisphosphonates and, despite suggesting that their results should be analyzed with caution due to the low level of evidence of the included studies, the meta-analysis showed that the use of platelet concentrates as an adjunct to oral surgery procedures may have a beneficial effect.…”

Section: Discussionmentioning

confidence: 99%

“…Del Fabbro et al 37 addressed the use of platelet concentrates in the treatment and prevention of osteonecrosis of the jaw associated with bisphosphonates and, despite suggesting that their results should be analyzed with caution due to the low level of evidence of the included studies, the meta-analysis showed that the use of platelet concentrates as an adjunct to oral surgery procedures may have a beneficial effect. Serrano et al 38 assessed whether the use of autologous platelet concentrates immediately after tooth extraction would prevent osteoradionecrosis in patients treated with radiotherapy for head and neck cancer, and according to the evidence found, a reliable statement could not be made despite studies suggesting that the use of autologous platelet concentrates does not seem to be beneficial for the evaluated cases.…”

Section: Discussionmentioning

confidence: 99%

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Use of platelet concentrates in oral surgery of patients with osteonecrosis: a scoping review

Rufato,

Prado,

Luft

et al. 2023

Braz. Dent. J.

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The objective of this study was to map, through a scoping review, the evidence available in the literature on the use of platelet concentrates in compromised patients undergoing oral surgeries. Searches were performed in electronic databases for clinical studies with compromised patients undergoing oral surgery who used platelet concentrates. Only studies published in English were included. Two independent researchers carried out the selection of studies. The study design and objective, surgical procedure and platelet concentrate used, systemic involvement, analyzed outcome, and main results were extracted. A descriptive analysis of the data was performed. Twenty-two studies met the eligibility criteria and were included. Case series was the most frequent study design among the included studies (41.0%). In terms of systemic disability, 19 studies reported patients with cancer and related to surgical treatment 16 studies reported patients underwent treatment for osteonecrosis related to the use of the drug. The most used platelet concentrate was pure platelet-rich fibrin (P-PRF). In general, most studies recommend the use of platelet concentrates. Thus, the results of this study suggest that the evidence related to the use of platelet concentrates in compromised patients when undergoing oral surgeries is still initial. Also, most studies assessed the use of platelet concentrates in patients with osteonecrosis.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Use of platelet concentrates in oral surgery of patients with osteonecrosis: a scoping review

Rufato,

Prado,

Luft

et al. 2023

Braz. Dent. J.

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“…In 1985, Marx et al [75] showed that HBO decreased ORN onset compared to patients treated with antibiotics following the removal of teeth, while the other study [76] could not identify any difference between the combined use of HBO and antibiotics compared to antibiotics alone. Although most of the literature focused on HBO [72] and autologous platelet concentrates [77] showing controversial findings, other medical approaches have been proposed, including the combined use of pentoxifylline and tocopherol (in the so-called PENTO protocol). Of note, in the majority of studies involving both HBO or PENTO protocol, the additional use of antibiotics was habitually prescribed [72].…”

Section: Preventive Strategies For Reducing the Risk Of Orn Related T...mentioning

confidence: 99%

Oral Surgery and Osteoradionecrosis in Patients Undergoing Head and Neck Radiation Therapy: An Update of the Current Literature

Corrao,

Mazzola,

Lombardi

et al. 2023

Biomedicines

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Osteoradionecrosis (ORN) is a serious long-term complication of head and neck radiotherapy (RT), which is often triggered by dental extractions. It results from avascular aseptic necrosis due to irradiated bone damage. ORN is challenging to treat and can lead to severe complications. Furthermore, ORN causes pain and distress, significantly reducing the patient’s quality of life. There is currently no established preventive strategy. This narrative review aims to provide an update for the clinicians on the risk of ORN associated with oral surgery in head and neck RT patients, with a focus on the timing suitable for the oral surgery and possible ORN preventive treatments. An electronic search of articles was performed by consulting the PubMed database. Intervention and observational studies were included. A multidisciplinary approach to the patient is highly recommended to mitigate the risk of RT complications. A dental visit before commencing RT is highly advised to minimize the need for future dental extractions after irradiation, and thus the risk of ORN. Post-RT preventive strategies, in case of dento-alveolar surgery, have been proposed and include antibiotics, hyperbaric oxygen (HBO), and the combined use of pentoxifylline and tocopherol (“PENTO protocol”), but currently there is a lack of established standards of care. Some limitations in the use of HBO involve the low availability of HBO facilities, its high costs, and specific clinical contraindications; the PENTO protocol, on the other hand, although promising, lacks clinical trials to support its efficacy. Due to the enduring risk of ORN, removable prostheses are preferable to dental implants in these patients, as there is no consensus on the appropriate timing for their safe placement. Overall, established standards of care and high-quality evidence are lacking concerning both preventive strategies for ORN as well as the timing of the dental surgery. There is an urgent need to improve research for more efficacious clinical decision making.

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“…In addition, whether or not surgical rehabilitation in the affected bone can be successful, or counterproductive is largely related to the bone status and surgical protocols [ 1 ]. Different methods including application of platelet-rich concentrates and preoperative administration of hyperbaric oxygen and antibiotics have been proposed for prevention of ORN incidence after bone manipulation in the irradiated jaws [ 5 , 6 ]. However, based on a Cochrane systematic review, due to the inadequate sample size and errors in reporting, the evidence on the potential of these agents for prevention from ORN is not certain [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Application of Platelet-Rich Fibrin and Bone Morphogenetic Protein for Full-Mouth Implant-Based Oral Rehabilitation in a Case of Mandibular Osteoradionecrosis

Moaddabi,

Soltani,

Yazdani

et al. 2023

Case Reports in Dentistry

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Osteoradionecrosis (ORN) is a debilitating complication following radiation therapy, which in the head and neck region, occurs most frequently in the mandible. Although ORN is rare, it is complex and multifactorial and requires appropriate management. Manipulation of bone in patients with head and neck cancers before radiotherapy can cause ORN. In this report, we aim to present successful insertion of four dental implants in the interforaminal segment combined with application of platelet-rich fibrin and bone morphogenetic protein in a 60-year-old male with stable ORN in the posterior regions of the mandible.

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Autologous platelet concentrates in extraction sockets for the prevention of osteoradionecrosis: a systematic review of controlled clinical trials

Cited by 3 publications

References 25 publications

Use of platelet concentrates in oral surgery of patients with osteonecrosis: a scoping review

Use of platelet concentrates in oral surgery of patients with osteonecrosis: a scoping review

Oral Surgery and Osteoradionecrosis in Patients Undergoing Head and Neck Radiation Therapy: An Update of the Current Literature

Application of Platelet-Rich Fibrin and Bone Morphogenetic Protein for Full-Mouth Implant-Based Oral Rehabilitation in a Case of Mandibular Osteoradionecrosis

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