scholarly journals Platelet Rich Plasma in the Treatment of Bisphosphonate-Related Osteonecrosis of the Jaw: Personal Experience and Review of the Literature

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
F. Longo ◽  
A. Guida ◽  
C. Aversa ◽  
E. Pavone ◽  
G. Di Costanzo ◽  
...  
Keyword(s):  
Surgical Therapy ◽  
Personal Experience ◽  
Platelet Rich Plasma ◽  
Osteonecrosis Of The Jaw ◽  
Bone Diseases ◽  
Definitive Evidence ◽  
Synthetic Drugs ◽  
Antiresorptive Agents ◽  
Nonsurgical Therapy ◽  
Prp Gel

Bisphosphonates (BPs) are a class of synthetic drugs commonly used to treat bone metastasis and various bone diseases that cause osseous fragility (such as osteoporosis). Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is a common complication in patients who received BPs, especially intravenously. Recently, osteonecrosis of the jaw (ONJ) caused by chemotherapeutic not belonging to BPs drug class has been reported. For this reason, it has been proposed recently to rename BRONJ in antiresorptive agents related osteonecrosis of the jaw (ARONJ), to include a wider spectrum of drugs that may cause osteonecrosis of the jaw. The most debated topic about ARONJ/BRONJ is therapy. The most adequate procedure is far from being standardized and prevention seems to play a pivotal role. In our study, we considered 72 patients with BRONJ with nonsurgical therapy, surgical therapy, and surgical therapy with platelet rich plasma (PRP) gel to evaluate its therapeutic effect in promoting ONJ wounds healing. Good results showed by PRP in improving wound healing give away to case-control randomized studies that could give definitive evidence of its effectiveness.

scholarly journals Medication-Related Osteonecrosis of the Jaw: a Brief Review, Treatment and Practical Guidelines for Dentists

2017 ◽  
Vol 2 (2) ◽  
pp. 117-121
Author(s):  
Ioana-Aurița Albu-Stan ◽  
Daniel-Emil Albu ◽  
Diana Cerghizan ◽  
Lia Yero Eremie ◽  
Kinga Jánosi ◽  
...  
Keyword(s):  
Bone Fractures ◽  
Malignant Tumors ◽  
Osteonecrosis Of The Jaw ◽  
Bone Diseases ◽  
Disease Stage ◽  
Mineral Density ◽  
Treatment Protocols ◽  
Antiresorptive Agents ◽  
Antiresorptive Drugs ◽  
Practical Guidelines

AbstractOsteonecrosis of the jaws is a complication after treatment with antiresorptive drugs. Bisphosphonates (BPs) are widely used to treat conditions with bone metastases of malignant tumors such as multiple myeloma, breast cancer, prostatic cancer, as well as hypercalcemia of malignancy, osteoporosis, Paget’s disease, and osteogenesis imperfecta. Denosumab is an antiresorptive agent that is used for the treatment of osteoporosis or metastatic bone diseases. These antiresorptive agents improve the quality of life of patients by increasing strength and bone mineral density, and reducing the risk of bone fractures. More than a decade had passed since the first publication of this pathology, and the occurrence of the disease, its pathophysiology, and proper treatment methods are still not fully elucidated. Prevention is critical in medication-related osteonecrosis of the jaw, because the treatment is difficult, and there are no universally accepted treatment protocols. There is an accepted approach of palliation of symptoms and controlling the associated infections. Treatment may follow one of three procedures: conservative management of pain, conservative or extensive (segmental) surgery, depending on the disease stage.

scholarly journals Surgical therapy for medication-related osteonecrosis of the jaw in osteoporotic patients treated with antiresorptive agents

2020 ◽  
Vol 164 (1) ◽  
pp. 100-107 ◽  
Author(s):  
Lukas Hauer ◽  
Jan Jambura ◽  
Daniel Hrusak ◽  
Miroslava Chalupova ◽  
Petr Posta ◽  
...  
Keyword(s):  
Surgical Therapy ◽  
Osteonecrosis Of The Jaw ◽  
Antiresorptive Agents

scholarly journals Surgical treatment of osteonecrosis associated with bisphosphonates: a case report

2017 ◽  
Vol 20 (3) ◽  
Author(s):  
Luisa Machado Barin ◽  
Fernanda Maia Pillusky ◽  
Raquel Cristine Silva Barcelos ◽  
Carlos Alberto Bazaglia Escobar ◽  
Cristiane Cademartori Danesi
Keyword(s):  
Conservative Treatment ◽  
Treatment Option ◽  
Surgical Therapy ◽  
Osteonecrosis Of The Jaw ◽  
Bone Diseases ◽  
Definitive Treatment ◽  
Surgical Removal ◽  
Oral Surgical Procedures ◽  
Treatment Protocols ◽  
Cancer History

<p>Bisphosphonates (BP) are routinely used in the management of metastatic bone diseases and malignancies neoplasms, but there is an adverse effect of their chronic use called bisphosphonate-related osteonecrosis of the jaw (BRONJ). Treatment for BRONJ is challenging and complex, as there is still no definitive treatment protocols and the various treatments described in the literature have success variables indexes. In this sense, this study aims to emphasize the responsibility of dentist about the knowledge of BRONJ and report a clinical case that the surgical therapy was the best treatment option. Male patient, sixty-nine years old, asked for dental care complaining about bone exposure. On the anamneses, he reported the use of BP due to cancer history. The intra oral examination revealed exposed bone in the lower right molar region extending to retromolar trigon region on lingual side. There was conservative treatment with antibiotic therapy and mouth rinses of chlorhexidine 0.12 %, but not obtaining success. Therefore, we opted for the surgical removal of necrotic bone area and the tooth involved. The postoperative was within normal standard. The knowledge of dentist about this pathology is essential to prevent, diagnose and treat this disease the most appropriate way. Although the treatment of BRONJ remains challenging and complex, surgical therapy is a treatment option for lesions in early clinical stages and resistant to conservative treatment, providing a better prognosis and quality of life for the patient.</p><p> </p><p><strong>Keywords</strong></p><p>Bisphosphonate-associated osteonecrosis; Mandible; Oral surgical procedures.</p>

scholarly journals Osteonecrosis of the jaw and antiresorptive agents in benign and malignant diseases: a critical review organized by ECTS

2021 ◽  
Author(s):  
Athanasios D Anastasilakis ◽  
Jessica Pepe ◽  
Nicola Napoli ◽  
Andrea Palermo ◽  
Christos Magopoulos ◽  
...  
Keyword(s):  
Bone Metastases ◽  
Bone Disease ◽  
Bone Lesion ◽  
Osteonecrosis Of The Jaw ◽  
Bone Diseases ◽  
Antiresorptive Therapy ◽  
Severe Condition ◽  
Antiresorptive Agents ◽  
Calcified Tissue ◽  
Prevention Of Cancer

Abstract Context Antiresorptive therapy significantly reduces fracture risk in patients with benign bone disease and skeletal-related events (SREs) in patients with bone metastases. Osteonecrosis of the jaw (ONJ) is a rare, but severe condition, manifested as necrotic bone lesion(-s) of the jaws. ONJ has been linked to the use of potent antiresorptive agents, termed as Medication Related ONJ (MRONJ). Methods A working group of the European Calcified Tissue Society (ECTS) and two experts performed an updated detailed review of existing literature on MRONJ incidence, characteristics, and treatment applied in bone diseases with variable severity of skeletal insult, ranging from osteoporosis to prevention of cancer treatment-induced bone loss and SREs in cancer patients with bone metastases. We aimed to identify the differences in various aspects of MRONJ among these distinct patient categories and provide recommendations on how to mitigate the risk and optimally manage MRONJ in each one of them. Results The risk for MRONJ is much higher in patients with advanced malignancies compared to those with benign bone diseases, because of the higher doses and more frequent administration of antiresorptive agents in individuals with compromised general health, along with co-administration of other medications that predispose to MRONJ. The overall risk for MRONJ is considerably lower than the benefits in all categories of patients. Conclusions The risk for MRONJ largely depends on the underlying bone disease and the relevant antiresorptive regimen applied. Physicians and dentists should keep in mind that the benefits of antiresorptive therapy far outweigh the risk for MRONJ development.

scholarly journals Application of a collagen scaffold saturated with platelet-rich plasma in prevention of bisphosphonate-related osteonecrosis of the jaw in the rat animal model

Heliyon ◽  
2021 ◽  
Vol 7 (5) ◽  
pp. e06930
Author(s):  
Farnoosh Razmara ◽  
Mohammad Bayat ◽  
Sadegh Shirian ◽  
Ghazal Shabankare ◽  
Abdolreza Mohamadnia ◽  
...  
Keyword(s):  
Animal Model ◽  
Platelet Rich Plasma ◽  
Collagen Scaffold ◽  
Osteonecrosis Of The Jaw ◽  
Rat Animal Model

scholarly journals Evaluation of platelet-rich plasma gel as an angiogenesis-inducing agent in canineadvancement skin flaps

2020 ◽  
Vol 40 (6) ◽  
pp. 474-478
Author(s):  
Grazielle A.S. Aleixo ◽  
Maria C.O.C. Coelho ◽  
Telga L.A. Almeida ◽  
Márcia F. Pereira ◽  
Miriam N. Teixeira ◽  
...  
Keyword(s):  
Blood Vessel ◽  
Skin Color ◽  
Platelet Rich Plasma ◽  
Skin Flap ◽  
Skin Flaps ◽  
Experimental Conditions ◽  
Significant Difference ◽  
Experimental Group ◽  
Prp Gel ◽  
Made In

ABSTRACT: This work aimed to evaluate the effect of platelet-rich plasma (PRP) on advancement skin flaps in dogs regarding improvement of vascularization, with focus on increasing its viable area, since there are reports that it is a potential angiogenesis stimulator. The experimental group was composed of eight adult bitches, in which two advancement skin flaps were made in the ventral abdominal region. No product was applied in the control flap (CF), while PRP was used in the contralateral flap, called treated flap (TF). The areas were clinically evaluated every two days until the 7th postoperative day regarding skin color and presence of necrosis. At 10 days, both flaps were removed and submitted to histological examination and blood vessel morphometry. The vessels counted in each group were statistically analyzed by the F-test at 1% probability. Results showed no significant difference in macroscopic changes in the wound, or CF and TF vascularization, thus suggesting that PRP gel did not improve advancement skin flap angiogenesis in bitches under the experimental conditions in which this research was developed.

Use of platelet-rich plasma in the treatment of bisphosphonate-related osteonecrosis of the jaw

2012 ◽  
Vol 41 (11) ◽  
pp. 1410-1415 ◽  
Author(s):  
S. Bocanegra-Pérez ◽  
M. Vicente-Barrero ◽  
M. Knezevic ◽  
J.M. Castellano-Navarro ◽  
E. Rodríguez-Bocanegra ◽  
...  
Keyword(s):  
Platelet Rich Plasma ◽  
Osteonecrosis Of The Jaw

Effectiveness of autologous platelet-rich plasma gel in the treatment of hard-to-heal leg ulcers: a randomised control trial

2019 ◽  
Vol 28 (10) ◽  
pp. 658-667 ◽  
Author(s):  
Domantas Rainys ◽  
Adas Cepas ◽  
Karolina Dambrauskaite ◽  
Irena Nedzelskiene ◽  
Rytis Rimdeika
Keyword(s):  
Platelet Rich Plasma ◽  
Size Reduction ◽  
Control Group ◽  
Leg Ulcers ◽  
Tissue Formation ◽  
Granulation Tissue Formation ◽  
Wound Contamination ◽  
Wound Size ◽  
Autologous Platelet Rich Plasma ◽  
Prp Gel

Objective: Regenerative medicine products such as autologous platelet-rich plasma (autologous PRP) gel may speed up the process of healing. Clinical studies show promising results in the treatment of diabetic foot ulcers (DFUs), however there is lack of scientific evidence of autologous PRP effectiveness in treating leg ulcers of other aetiology. This study evaluates the effectiveness of autologous PRP gel in the treatment of hard-to-heal leg ulcers compared with existing conventional treatment. Method: A prospective, randomised controlled, open-labelled clinical trial was carried out between 2014 and 2018. An eight-week study protocol was chosen or until 100% wound re-epithelialisation was observed. Wound size reduction, granulation tissue formation, microbiological wound bed changes and safety were evaluated. Results: A total of 69 patients (35 in the autologous PRP group and 34 in the control group) were included in the study; 25.71% of the autologous PRP group and 17.64% of control group had ulcers completely re-epithelialised (p>0.05). Wound size reduction in the autologous PRP group was 52.35% and 33.36% in the control group (p=0.003). The autologous PRP group showed superiority over conventional treatment in wound bed coverage with granulation (p=0.001). However, more frequent wound contamination was observed at the end of treatment in the autologous PRP group (p=0.024). No severe adverse events were noted during the study. Both treatment methods were considered equally safe. Conclusion: Topical application of autologous PRP gel in leg ulcers of various aetiology show beneficial results in wound size reduction and induces the granulation tissue formation. However, it is associated with more frequent microbiological wound contamination.

Development of Antiresorptive Agent-Related Osteonecrosis of the Jaw After Dental Implant Removal: A Case Report

2018 ◽  
Vol 44 (5) ◽  
pp. 359-364
Author(s):  
Shinsuke Yamamoto ◽  
Keigo Maeda ◽  
Izumi Kouchi ◽  
Yuzo Hirai ◽  
Naoki Taniike ◽  
...  
Keyword(s):  
Dental Implants ◽  
Dental Implant ◽  
Osteonecrosis Of The Jaw ◽  
Japanese Woman ◽  
Implant Removal ◽  
Antiresorptive Agent ◽  
Oral Bisphosphonate ◽  
Antiresorptive Agents ◽  
The Right ◽  
Implant Treatment

Dental implant treatment is a highly predictable therapy, but when potentially lethal symptoms or complications occur, dentists must remove the implant fixture. Recently, reports on antiresorptive agent-related osteonecrosis of the jaw have increased in the field of dental implants, although the relationship between dental implant treatment and antiresorptive agents remains unclear. Here, we report a case of antiresorptive agent-related osteonecrosis of the jaw that developed after dental implant removal. A 67-year-old Japanese woman with a medical history of osteoporosis and 7 years of oral bisphosphonate treatment was referred to our hospital with a chief complaint of painful right mandibular bone exposure. A family dentist removed the dental implants from the right mandible using a trephine drill without flap elevation in August 2016. However, the healing was impaired; she was referred to our hospital 3 months after the procedure. We performed a sequestrectomy of the mandible under general anesthesia. In conclusion, this patient's course has two important implications: First, the removal of dental implants from patients who are prescribed oral bisphosphonates for long durations can cause antiresorptive agent-related osteonecrosis of the jaw. Second, meticulous procedures are required to prevent and treat the development of antiresorptive agent-related osteonecrosis of the jaw after dental implant removal.

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