Management of Medication-Related Osteonecrosis of the Jaw (MRONJ) Using Leukocyte- and Platelet-Rich Fibrin (L-PRF) and Photobiomodulation: A Retrospective Study

Abstract

Background. The aim of this study was to compare retrospectively the effect of three different treatment protocols on the healing outcome in patients with established medication-related osteonecrosis of the jaw (MRONJ). Methods. A total of 34 MRONJ patients were recruited from the Department database and were divided according to the treatment protocols in a study group (G1) and two control groups (G2 and G3). G1 was treated with antibiotic therapy, surgery, leukocyte- and platelet-rich fibrin (L-PRF), and photobiomodulation; G2 was treated with antibiotic therapy and surgery; G3 was treated with antibiotic therapy and photobiomodulation. Various clinical variables and treatment protocols were analyzed to determine their correlation with the healing outcome at three and six months of follow-up. Results. There was a significant association between the different treatment protocols and the outcomes at both three and six months follow-up (p = 0.001 and p = 0.002, respectively). No significant association was observed between the outcomes and MRONJ localization, MRONJ stage, duration of drug treatment, gender, diabetes, corticosteroid therapy, smoking habits, underlying disease, and history of chemotherapy at both three and six months follow-up. Conclusions. Our results show that the combination of antibiotic therapy, surgery, L-PRF, and photobiomodulation may effectively contribute to MRONJ management.

Complementarity of Photo-Biomodulation, Surgical Treatment, and Antibiotherapy for Medication-Related Osteonecrosis of the Jaws (MRONJ)

“…Such an approach is confirmed by recent studies, which point out to the better effectiveness of combining different techniques for treating MRONJ [ 73 ], but also to the necessity to diagnose it early and to treat it efficiently [ 74 ]. Other recent aspects of interest refer to telemedicine approaches of such conditions in pandemic situations [ 75 ].…”

Autologous Platelet-Rich Fibrin (PRF) as an Adjunct in the Management of Osteoradionecrosis and Medication-Related Osteonecrosis of Jaws. Case Series in A Single Centre

“…Recent studies on the use of L-PRF on MRONJ showed successful short-term results, i.e., mucosal integrity, absence of infection, and pain evaluation [56]; however, there was no statistically significant difference in terms of improvement between APC application and surgical treatment [57], and combination of antibiotic therapy, surgery, L-PRF, and photobiomodulation may contribute to MRONJ management [58]. In addition, recent reports on L-PRF and ORN showed good results on the healing [46,50].…”

Antirreabsortivos ósseos em pacientes odontológicos: noções de conduta para o cirurgião-dentista: uma revisão integrativa/ Bone antiresorptive drugs in dental patients: notions of conduct for dentists: an integrative review

“…Os concentrados de plaquetas adicionam fatores de crescimento no local cirúrgico e têm sido usados em um número de estudos para acelerar o osso e cicatrização de tecidos moles 37 . 40 . Pode-se concluir que o uso desse método é eficaz em muitos casos, podendo ser considerado uma alternativa terapêutica viável 35 .…”