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.
Highlights
Medication-related osteonecrosis of the jaw (MRONJ) is a relatively rare serious adverse drug reaction
The American Association of Oral and Maxillofacial Surgeons (AAOMS) has recommended considering this complication being related to medications rather than being related only to bisphosphonates and changed the nomenclature of this complication into medication-related osteonecrosis of the jaw (MRONJ) [3]
The following question was structured according to the PICO study design: Which treatment strategy was more effective for the management of MRONJ patients? The patients were recruited by querying the Department database from January 2019 to March 2020
Summary
Medication-related osteonecrosis of the jaw (MRONJ) is a relatively rare serious adverse drug reaction. It is defined as an area of exposed or probed bone persisting for more than eight weeks in the maxillofacial region in patients with ongoing or a history of treatment with bone-modifying agents and/or angiogenic inhibitor agents [1,2,3]. 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). 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. Our results show that the combination of antibiotic therapy, surgery, L-PRF, and photobiomodulation may effectively contribute to MRONJ management
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