Abstract
Osteoradionecrosis (ORN) of the jaws and medication-related osteonecrosis of the jaws (MRONJ) are uncommon but serious diseases affecting the oral and maxillofacial region with clinically similar appearance but distinct pathophysiology. Management of ORN and MRONJ is inherently challenging and the treatment outcomes are unpredictable. The use of autologous platelet concentrates (APCs) to promote hard and soft tissue healing is well described in the literature, and the efficacy of leucocyte and platelet-rich fibrin (L-PRF) has been well documented in a number of clinical studies. The aim of this study was to present our treatment strategy and the outcomes of incorporating L-PRF as a surgical adjunct in management of ORN and MRONJ in our centre. Methods: eight cases of ORN and MRONJ were treated with a combination of sequestrectomy and L-PRF as a surgical adjunct. Results: the overall success was 87.5%. Using L-PRF as an adjunct, we were able to predictably manage ORN and MRONJ without causing significant morbidity. Conclusion: our experience shows that L-PRF may be used as a valuable and cost-effective adjunct to surgical management of ORN and MRONJ. However, due to a limited number of patients, and a short period of review, the true effectiveness of the method is yet to be demonstrated in a longer follow-up study including a greater number of patients, besides the inclusion of a control group.
Highlights
Fibrin adhesives were used in oral and maxillofacial surgery for hemostasis after dental extraction in patients with clotting disorders, neural anastomoses, and skin grafts placement, in combination with the use of bone grafts for alveolar ridge augmentation and filling of bony cavities following cyst removal [1]
An autologous fibrin adhesive (AFA) was added to a cancellous bone graft during mandibular reconstruction, and the results demonstrated earlier radiographic bone consolidation compared to bone grafts without AFA [2]
The first use of autologous platelet concentrates (platelet-rich plasma (PRP)) in maxillofacial surgery was introduced by Marx et al in 1998, in which at least three growth factors (platelet-derived growth factor (PDGF), transforming growth factor beta 1 (TGF-β1), and transforming growth factor beta 2 (TGF-β2) were identified in PRP
Summary
Fibrin adhesives were used in oral and maxillofacial surgery for hemostasis after dental extraction in patients with clotting disorders, neural anastomoses, and skin grafts placement, in combination with the use of bone grafts for alveolar ridge augmentation and filling of bony cavities following cyst removal [1]. An autologous fibrin adhesive (AFA) was added to a cancellous bone graft during mandibular reconstruction, and the results demonstrated earlier radiographic bone consolidation compared to bone grafts without AFA [2]. Platelet concentrate refers to an autologous concentration of human platelets obtained by centrifuging blood. This results in a high concentration of several protein growth factors secreted actively by platelets. The first use of autologous platelet concentrates (platelet-rich plasma (PRP)) in maxillofacial surgery was introduced by Marx et al in 1998, in which at least three growth factors (platelet-derived growth factor (PDGF), transforming growth factor beta 1 (TGF-β1), and transforming growth factor beta 2 (TGF-β2) were identified in PRP. Up to the present time, controversy surrounds the efficacy of PRP and its true role in osteoinduction [4,5,6]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
