The use of Platelet-rich Fibrin in the management of medication-related osteonecrosis of the jaw: A case series.

Fernando de Almeida Barros Mourão, C; Calasans-Maia, M D; Del Fabbro, M; Le Drapper Vieira, F; Coutinho de Mello Machado, R; Capella, R; Miron, Richard John; Gomes Alves, G (2020). The use of Platelet-rich Fibrin in the management of medication-related osteonecrosis of the jaw: A case series. Journal of stomatology, oral and maxillofacial surgery, 121(1), pp. 84-89. Elsevier 10.1016/j.jormas.2019.02.011

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Medication related osteonecrosis of the jaw (MRONJ) is characterized by exposed necrotic bone in the maxillofacial region that persists for more than eight weeks in patients taking antiresorptive or antiangiogenic drugs for bone metastasis or osteoporosis. The management of such condition depends on several factors, among which the staging of MRONJ. Though, a specific gold standard treatment has not been established to date. The aim of this case series is to describe the outcome of surgical treatment of MRONJ with the adjunct of Platelet-rich Fibrin (PRF). Eleven patients under therapy with alendronate underwent surgical removal of necrotic bone and debridement, followed by placement of PRF membranes in the bone defect. The outcome of the surgical treatment was successful in all patients, in a follow-up range from 12 to 36 months. In the cases presented, the macroscopic evaluation showed excellent and fast soft tissue healing, with no recurrence of bone exposure and no signs of infections. PRF membranes were also effective for postsurgical pain control. The use of PRF may represent a valuable adjunct in the surgical management of MRONJ.

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