Use of Allogeneic Platelet Concentrates for the Surgical Treatment of Bisphosphonate -Related Osteo-Necrosis of Jaws (BRONJ): A Case

(Pages: 8-13)

S. Ragazzini1, R. Parrulli2, R. Ippolito3, L. Montebugnoli4 and C. Marchetti5

1Department of Biomedical Science and Neuromotor – DIBINEM, Alma Mater Studiorum University of Bologna, Italy; 2Department of Biomedical Science and Neuromotor, Alma Mater Studiorum University of Bologna, Italy; 3Department of Biomedical Science and Neuromotor, Alma Mater Studiorum University of Bologna, Italy; 4Department of Biomedical and Neuromotor Science, Section of Oral Sciences, University of Bologna, Italy; 5Maxillofacial Surgery, Faculty of Medicine, Alma Mater Studiorum University of Bologna, Italy

DOI: http://dx.doi.org/10.30576/2414-2050.2019.05.2

 

 

Abstract: ONJ management is controversial. There are no evidence-based guidelines. The aim of this study was to assess the positive effects of the application of allogeneic PRP in association with conservative surgery in the treatment of BRONJ.

Methods: The cohort consisted of 19 patients (7 males, 12 females, aged mean 68.4years) with a diagnosis of BRONJ. All surgical procedures took place in the same unit under general anesthesia. Preparation of a mucoperiosteal flap and removal of all infected and necrotic bone using surgical drills.
After bone curettage, homologous PRP was applied topically. The platelets used for the preparation of PRP gel were derived from a platelet apheresis procedure.

Results: No intraoperative or postoperative complication was observed. At the time of suture removal, only four patients showed minimal bone exposure with no sign of acute infection. These patients continued to show bone exposure in the absence of pain or infection at the 6-month follow-up. The remaining patients (79%) presented complete mucosal healing and no sign of exposed necrotic bone during the follow-up period of 6‒18 (mean 9) months.

Conclusion: Although there is a need for further studies, allogeneic PRP treatment resulted in improved soft tissue healing after surgery for osteonecrosis.

Keywords: Bisphosphonates, Allogeneic PRP, Surgery.