Management of Early Case of Maxilla Osteonecrosis in Patient with Bone Metastases on Bisphosphonates Using Platelet-Rich Fibrin as Adjuvant: Case Report

Abstract

Although it remains relatively rare, osteonecrosis of the mandible and/or maxilla induced by intravenous infusion of bisphosphonates in patients suffering from bone metastatic cancers is a serious complication that affects the oral and maxillofacial region, its repercussion can be heavy and impacts quite negatively the patient's quality of life, despite its management is uncertain and complicated, a rapid intervention with a conservative approach if it is possible strengthen with the use of platelet-rich fibrin (PRF) as adjuvant seems to be very effective, thus enhancing the bone healing, limiting current manifestations and prevent more serious and extended complications. In this case report, we present a good evolution of an early stage of maxillary osteonecrosis that appeared four weeks after dental extraction by a general practitioner in a 60-year-old female treated with IV Bisphosphonates, IV Herceptin and Arimidex for bone metastatic breast cancer using conservative treatment combined with the use of autologous platelet-rich fibrin.