Leucocyte-rich and platelet-rich fibrin for the treatment of bisphosphonate-related osteonecrosis of the jaw: a prospective feasibility study

Br J Oral Maxillofac Surg. 2014 Nov;52(9):854-9. doi: 10.1016/j.bjoms.2014.07.256. Epub 2014 Aug 16.

Abstract

Our aim was to assess the feasibility of using leucocyte-rich and platelet-rich fibrin (L-PRF) for the treatment of bisphosphonate-related osteonecrosis of the jaw (BRONJ) in a single group study. After treatment with L-PRF, the response of each patient was recorded 1 month and 4 months postoperatively. Further assessments were made of the site, stage, concentration of c-terminal crosslinked telopepide of type 1 collagen, and actinomycosis. Among the total of 34 patients, 26 (77%) showed complete resolution, 6 (18%) had delayed resolution, and 2 (6%) showed no resolution. There was a significant association between the response to treatment and the stage of BRONJ (p=0.002) but no other significant associations were detected. This study has shown that it is feasible to use L-PRF for the treatment of BRONJ, but the effectiveness cannot be judged with this study design. Randomised prospective trials are needed to confirm this.

Keywords: Bisphosphonate; Growth factor; Osteonecrosis of the jaw; Platelet concentrate; Platelet-rich fibrin.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Actinomycosis / pathology
  • Aged
  • Biopsy / methods
  • Bisphosphonate-Associated Osteonecrosis of the Jaw / classification
  • Bisphosphonate-Associated Osteonecrosis of the Jaw / surgery
  • Bisphosphonate-Associated Osteonecrosis of the Jaw / therapy*
  • Blood Platelets / physiology*
  • Collagen Type I / blood
  • Debridement / methods
  • Feasibility Studies
  • Female
  • Fibrin / therapeutic use*
  • Follow-Up Studies
  • Humans
  • Leukocytes / physiology*
  • Mandibular Diseases / classification
  • Mandibular Diseases / surgery
  • Mandibular Diseases / therapy
  • Maxillary Diseases / classification
  • Maxillary Diseases / surgery
  • Maxillary Diseases / therapy
  • Middle Aged
  • Peptides / blood
  • Pilot Projects
  • Prospective Studies
  • Therapeutic Irrigation / methods
  • Treatment Outcome
  • Wound Healing / physiology

Substances

  • Collagen Type I
  • Peptides
  • collagen type I trimeric cross-linked peptide
  • Fibrin