Comment on “The Effect of Platelet-Rich Fibrin Membrane in Surgical Therapy of Medication-Related Osteonecrosis of the Jaw” by Szentpeteri et al

Abstract

To the Editor:—It was a great pleasure to read the article by Szentpeteri et al 1 Szentpeteri S. Schmidt L. Restar L. et al. The effect of platelet-rich fibrin membrane in surgical therapy of medication-related osteonecrosis of the jaw. J Oral Maxillofac Surg. 2020; 78: 738 Abstract Full Text Full Text PDF PubMed Scopus (5) Google Scholar on the positive effect of the membranous form of platelet-rich fibrin (PRF) in surgical therapy of medication-related osteonecrosis of the jaw (MRONJ). Their analysis of a retrospective cohort study of 101 patients with second- or third-stage MRONJ showed the significant superiority of surgery with PRF membranes (group 2) compared with surgery without PRF membranes (group 1) over the long-term. 1 Szentpeteri S. Schmidt L. Restar L. et al. The effect of platelet-rich fibrin membrane in surgical therapy of medication-related osteonecrosis of the jaw. J Oral Maxillofac Surg. 2020; 78: 738 Abstract Full Text Full Text PDF PubMed Scopus (5) Google Scholar We agree with Szentpeteri et al that PRF contains thrombocytes and stem cells, as well as a wide variety of growth factors, and may induce local angiogenesis and bone remodeling for disease improvement in patients with MRONJ. We and other researchers also have used well-vascularized local flaps containing stem cells to cover the exposed bone after extensive surgery, and this technique achieved excellent disease resolution in patients with MRONJ. 2 Myoken Y. Fujita Y. Okamoto T. Modified submental island flap for the surgical treatment of four patients with stage 3 medication-related osteonecrosis of the mandible. J Oral Maxillofac Surg. 2020; 78: 29 Abstract Full Text Full Text PDF PubMed Scopus (6) Google Scholar , 3 Lemound J. Muecke T. Zeller A.N. et al. Nasolabial flap improves healing in medication-related osteonecrosis of the jaw. J Oral Maxillofac Surg. 2018; 76: 877 Abstract Full Text Full Text PDF PubMed Scopus (19) Google Scholar , 4 Lemound J. Eckardt A. Kokemüller H. et al. Bisphosphonate-associated osteonecrosis of the mandible: Reliable soft tissue reconstruction using a local myofascial flap. Clin Oral Invest. 2012; 16: 1143 Crossref PubMed Scopus (41) Google Scholar However, as a critical evaluation of the work of Szentpeteri et al, we have some queries that we hope the authors will address.