scholarly journals Use of Platelet Rich Fibrin (PRF)-Based Autologous Membranes for Tooth Extraction in Patients under Bisphosphonate Therapy: A Case Report

Biomedicines ◽  
2019 ◽  
Vol 7 (4) ◽  
pp. 89 ◽  
Author(s):  
Alberto Pispero ◽  
Ivan Bancora ◽  
Antonious Khalil ◽  
Dario Scarnò ◽  
Elena M. Varoni
Keyword(s):  
Tooth Extraction ◽  
Osteonecrosis Of The Jaw ◽  
Bisphosphonate Therapy ◽  
Surgical Wound ◽  
Promising Alternative ◽  
Platelet Rich Fibrin ◽  
Premolar Extraction ◽  
Extraction Site ◽  
Antibiotic Coverage

Tooth extraction in patients treated with bisphosphonates (BPs) for osteoporosis or cancer exposes the patient to the risk of osteonecrosis of the jaw. An autologous membrane using platelet-rich fibrin (PRF) is an innovative technique to promote wound healing, which allows obtaining a hermetic closure of the post-extractive surgical site without the need of mucoperiosteal flaps or periosteal releasing incisions. Here, we report the case of a 70-year-old woman, in therapy with alendronate for 12 years, requiring the upper right premolar extraction because of a crown fracture. After the tooth extraction performed under antiseptic and antibiotic coverage, the PRF autologous membrane was placed on the surgical wound to close completely the post-extraction site. Follow-up visits were carried out after one, two, four weeks and two months from the intervention. The complete re-epithelization of the wound was observed without signs of infection. The use of PRF for the closure of post-extraction sockets in patients taking BPs appears to be a promising alternative to the more invasive surgical procedures. Future clinical trials will be pivotal in elucidating the effectiveness of PRF to prevent BP-related osteonecrosis after tooth extraction.

Use of Platelet-Rich Fibrin for Jaw Osteonecrosis: A Case Report

2020 ◽  
Vol 13 (2) ◽  
pp. 139-139
Author(s):  
Petya G. Kanazirska ◽  
Mery A. Hristamyan-Cilev ◽  
Nikolay D. Kanarinski
Keyword(s):  
Tooth Extraction ◽  
Osteonecrosis Of The Jaw ◽  
Hospital Treatment ◽  
Promising Alternative ◽  
Maxillary Bone ◽  
Platelet Rich Fibrin ◽  
Innovative Method ◽  
Healing Wound ◽  
Upper Jaw ◽  
Jaw Osteonecrosis

Summary We present tooth extraction in a patient treated with bisphosphonates (BPs) for cancer and at risk of osteonecrosis of the jaw. The administration of platelet-rich fibrin (PRF) is an innovative method of promoting wound healing that allows hermetic closure at the surgical site after extraction without mucoperiosteal flaps or periosteal release sections. Here, we describe the case of a 60-year-old man who had osteonecrosis of the upper jaw and underwent surgery for prostate cancer in 2012. In 2014, bone metastases were detected, and the patient was treated with Xgeva and Zometa: a two-year therapy with Xgeva, followed by treatment with Zometa. In 2018, after extraction of a tooth in the upper right jaw, a healing wound of extraction and stripping of the maxillary bone occurred. The patient was admitted for hospital treatment and underwent surgery to remove the osteonecrotic lesion, sequester and administer PRF (platelet-rich fibrin), and sew tightly. As a result of the treatment, complete re-epithelialization of the wound without infection occurred. Generally, in more invasive surgical procedures, the use of PRF to close the wells after extraction in patients receiving BP appears to be a promising alternative. Additional clinical trials will be essential t to clarify the effectiveness of PRF in preventing BP-related osteonecrosis after tooth extraction.

scholarly journals Management of Medication-Related Osteonecrosis of the Jaw (MRONJ) Using Leukocyte- and Platelet-Rich Fibrin (L-PRF) and Photobiomodulation: A Retrospective Study

2020 ◽  
Vol 9 (11) ◽  
pp. 3505
Author(s):  
Gianluca Tenore ◽  
Angela Zimbalatti ◽  
Federica Rocchetti ◽  
Francesca Graniero ◽  
Domenico Gaglioti ◽  
...  
Keyword(s):  
Antibiotic Therapy ◽  
Underlying Disease ◽  
Osteonecrosis Of The Jaw ◽  
Study Group ◽  
Stage Duration ◽  
Control Groups ◽  
Treatment Protocols ◽  
Platelet Rich Fibrin ◽  
History Of

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.

Tooth Extraction Locally Stimulates Proliferation of Multiple Myeloma in a Patient with Mandibular Localizations

2017 ◽  
Vol 138 (4) ◽  
pp. 201-207 ◽  
Author(s):  
Jean-Daniel Kün-Darbois ◽  
Léonie Quenel ◽  
Smaïl Badja ◽  
Daniel Chappard
Keyword(s):  
Multiple Myeloma ◽  
Tooth Extraction ◽  
Soft Tissues ◽  
Plasma Cells ◽  
Osteonecrosis Of The Jaw ◽  
Surgical Trauma ◽  
Osteolytic Lesions ◽  
X Ray ◽  
Extraction Site ◽  
The Right

Objectives: Multiple myeloma (MM) is characterized by the occurrence of osteolytic lesions. MM treatment usually involves antiresorptive drugs (mainly bisphosphonates). Case Report: A patient with an MM presented osteolytic lesions of the mandible. Extraction of teeth 45 and 46 was performed 5 years after the diagnosis of periodontitis. Four months later, osteonecrosis of the jaw (ONJ) was diagnosed at the extraction site. X-ray showed an extension of osteolytic lesions on the right side, close to the extraction site, without modification of the lesions on the left side. Two months later, a curettage was performed because of a painful bone sequestration. X-ray showed an extension of the osteolytic lesions on the right side. Results: Histological analysis found a vascularized plasmacytoma of the soft tissues around the ONJ. Analysis of the bone showed mixed lesions with osteonecrotic areas and living bone resorbed by active osteoclasts surrounding a plasmacytoma. The surface area of the osteolytic foci has considerably increased only close to the extraction site. Conclusions: Tooth extraction triggered an ONJ associated with bisphosphonate treatment. However, it also seemed to induce a considerable proliferation of plasma cells at the extraction site; we hypothesize that it is due to the increase in bone remodeling related to the surgical trauma.

Dental care and tooth extraction as a risk factor for developing osteonecrosis of the jaw after long-term bisphosphonate therapy in patients with metastatic breast cancer

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 1076-1076
Author(s):  
P. Spadaro ◽  
V. Pitini ◽  
G. Altavilla ◽  
M. Ingemi ◽  
G. Dottore
Keyword(s):  
Breast Cancer ◽  
Risk Factor ◽  
Bone Metastasis ◽  
Dental Care ◽  
Tooth Extraction ◽  
Statistical Significance ◽  
Significant Proportion ◽  
Metastatic Breast ◽  
Osteonecrosis Of The Jaw ◽  
Bisphosphonate Therapy

1076 Background: Association between osteonecrosis of the jaw (ONJ) and bisphosphonate treatment in patients (pts.)with Multiple Myeloma, breast cancer and prostate cancer has been increasingly reported in the literature. Risk factor for this complication include presence of infection, recent dental extraction and any oral surgical procedure with bone exposure. Methods: This is a retrospective review of our experience with patients diagnosed with bone metastasis secondary to breast cancer, who developed ONJ while treated with bisphosphonates, between January 2002 and December 2006. Presentation, age, dental status, and outcome were reviewed. Logistic Regression was used to test for statistical significance. Results: 100 pts. with bone metastasis secondary to breast cancer, median age 63 years, treated with bisphosphonates were reviewed. ONJ developed in 5 (5%) pts. Age did not impact occurrence of ONJ. All 5 patients developed ONJ after a minimum of 100mg of Zoledronic Acid and 2700mg of Pamidronate. All pts. had a history of previous tooth extraction and inadequate dental care. Three pts. were treated with debridement and antibiotics and their lesions healed. Two pts. ended up suffering from a chronically exposed bone. Conclusions: ONJ is a serious complication of bisphosphonate therapy and it affected a significant proportion of our patients. Our data suggests a strong association between dental care, tooth extraction, and the development of ONJ. No significant financial relationships to disclose.

scholarly journals Application of Platelet-Rich Fibrin as Regeneration Assistant in Immediate Auototransplantation of Third Molar with Unformed Roots: Case Report and Review of Literature

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Hamzah Alkofahi ◽  
Alaa Maghaireh ◽  
Mamoon Fnaish ◽  
Mohammad Jarrah ◽  
Mohammad Bataineh
Keyword(s):  
Skeletal Maturity ◽  
Healing Process ◽  
Third Molar ◽  
Periodontal Ligament Cells ◽  
Case Presentation ◽  
Platelet Rich Fibrin ◽  
Tooth Transplantation ◽  
Periodontal Tissues ◽  
Extraction Site

Background. Autogenous Tooth Transplantation (ATT) is the surgical movement of a maturely or immaturely formed tooth from its original site to another extraction site or a surgically prepared socket in the same individual. The most important factor in the healing process after autotransplantation is the presence of intact and viable periodontal ligament cells, which have the ability to differentiate into osteoblasts and able to induce bone production. ATT can successfully replace removable dentures as a restoration option in a growing patient, while implants can be placed only after skeletal maturity is attained. Case Presentation. In this case, we presented an immediate ATT of the third molar with unformed roots to the extraction socket of the first molar with evidence of continued root formation after 2 years of follow-up. Conclusion. Platelet-Rich Fibrin (PRF) can induce sustainable and accelerated healing, and it can also induce the regeneration process of the periodontal tissues and pulpal formation. This process plays a key role in future root development and success rate.

scholarly journals A pragmatic window of opportunity to minimise the risk of MRONJ development in individuals with osteoporosis on Denosumab therapy: a hypothesis

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Giuseppina Campisi ◽  
Rodolfo Mauceri ◽  
Francesco Bertoldo ◽  
Vittorio Fusco ◽  
Alberto Bedogni
Keyword(s):  
Tooth Extraction ◽  
Oral Surgery ◽  
Metastatic Cancer ◽  
Bone Fragility ◽  
Osteonecrosis Of The Jaw ◽  
Time Interval ◽  
Dental Surgery ◽  
Metabolic Bone ◽  
Increased Risk

Abstract Denosumab is associated with the development of medication-related osteonecrosis of the jaw (MRONJ), an uncommon but severe oral side effect with a higher prevalence in metastatic cancer patients than in patients with metabolic bone fragility. Although several oral triggers can initiate MRONJ, invasive oral treatments and tooth extraction still remain the most common precipitating event. In general, tooth extraction and oral surgery should be avoided in patients at increased risk of MRONJ, while extraction of non-restorable teeth should be performed based on specific risk reduction protocols to eliminate dental/periodontal infections, still protecting from MRONJ onset. Based on the different pharmacological activity of denosumab and nitrogen-containing bisphosphonates, it is likely that the MRONJ risk profile of patients with osteoporosis could somewhat vary. We hypothesize the chance to maximize the pharmacokinetic of denosumab 60 mg (Prolia®) and identify a time interval in which invasive oral treatments can ideally take place without restrictions in patients with metabolic bone fragility, We propose that dental surgery (e.g. tooth extraction) may be safely performed without additional intra or peri-operative procedures in osteoporosis patients using denosumab provided that careful case selection, adequate communication among specialists, planning of a delayed dosing window (1-month deferral) and rigorous postoperative follow-up are granted. Graphical abstract

scholarly journals Possible Role of Oral Ibandronate Administration in Osteonecrosis of the Jaw: A Case Report

2012 ◽  
Vol 25 (1) ◽  
pp. 311-316 ◽  
Author(s):  
A. Notarnicola ◽  
S. Lisi ◽  
M. Sisto ◽  
A.V. De Marino ◽  
M. D'Amore
Keyword(s):  
Risk Factors ◽  
Osteonecrosis Of The Jaw ◽  
Bisphosphonate Therapy ◽  
Caucasian Woman ◽  
Oral Bisphosphonate ◽  
Antiresorptive Drugs ◽  
Magnetic Resonance Imaging Mri ◽  
Alternative Medications

We describe a case of Osteonecrosis of the Jaw (ONJ) that developed in a 65-year-old Caucasian woman with osteopenia and other risk factors who was receiving low doses of oral bisphosphonate therapy (ibandronate, 150 mg monthly). Computed tomography (CT), panoramic radiographs (OPT), 99mTc-Sn-MDP scintigraphy, and magnetic resonance imaging (MRI) were performed to study the diseased area; cytological examination also revealed the presence of suppurative material around the area of exposed bone. A diagnosis of bisphosphonate-related osteonecrosis of the jaw complicated by osteomyelitis was made. The patient was prescribed a drug protocol consisting of metronidazole 250 mg 2 times daily, chlorhexidine mouthwashes 3 times daily and chewing exercises for two months. Ibandronate was stopped and replaced with strontium ranelate. The symptoms improved and the patient is still under close follow-up. Assessment of the benefits versus risks is particularly necessary in patients with several risk factors to ascertain their eligibility for treatment with antiresorptive drugs and when this is not possible to choose alternative medications.

scholarly journals RISK FACTORS IN PATIENTS WITH BISPHOSPHONATE - ASSOCIATED OSTEONECROSIS OF THE JAWS

2021 ◽  
Vol 27 (1) ◽  
pp. 3543-3548
Author(s):  
Meri Hristamyan ◽  
◽  
Ralitsa Raycheva ◽  
Petia Pechalova ◽  
Veselka Hristamyan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Tooth Extraction ◽  
Average Duration ◽  
Osteonecrosis Of The Jaw ◽  
Bisphosphonate Therapy ◽  
Imaging Studies ◽  
Significance Level ◽  
Facial Surgery ◽  
Prospective Epidemiological Study ◽  
Former Smokers

Purpose: To investigate patient diagnosed with BAONJ in order to identify the presence of risk factors. Material/Methods: A prospective epidemiological study of 112 patients diagnosed with Bisphosphonate-associated Osteonecrosis of the jaw in 2016 and 2017 was conducted in the Clinic of maxillo-facial surgery of UMHAT "St. George", Plovdiv, Bulgaria, based on anamnesis, clinical examination, hospital documentation, and imaging studies. SPSS Statistics v.24 was used for statistical analysis, at a significance level p<0.05. Results: Of the patients, 77.89% had a primary oncological diagnosis of breast or prostate cancer; the average duration of bisphosphonate therapy up to the time of the study is 4.5 years; the most common co-morbidities were hypertension (72.73%), anemia (40.00%) and diabetes (23.67%); 65.18% of patients smoke or are former smokers; the time till first oral complaints after initiation of BP treatment was usually 2 years (31.25%, n = 35) and 3 years (24.11%, n = 27) (p> 0.05).; the last dental manipulation before the onset of symptoms was tooth extraction (52.68%), followed by removable dentures (21.42%). Conclusions: The investigation of identified in the literature risk factors with their occurrence in the studied population shows a correlation with the data of leading researchers.

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