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Stomatologija 2020; 22 (1): 23-7 216 KB

Autologous platelet concentrates in treatment of medication related osteonecrosis of the jaw

Henrikas Rusilas¹, Aušra Balčiūnaitė², Juozas Žilinskas³

Summary

Background. Medication related osteonecrosis of the jaw (MRONJ) is a severe adverse drug reaction occurring as a progressive bone destruction in the maxillofacial region. MRONJ is usually initiated after oral surgery procedures, however periodontal disease and other chronic inflammations are also risk factors. There is no clear treatment protocol for management of MRONJ, for this reason autologous platelet concentrates (APC) have been introduced to enhance the healing process.

Aim. To evaluate the effectiveness of APCs in treatment of MRONJ.

Methods. A systematic literature review was performed according to PRISMA guidelines in MEDLINE (PubMed) and Google Scholar databases. Only no older than 5 years, in vivo studies in English with follow-up until condition totally resolves were included.

Results. A total of 2683 publications were identified out of which only 7 met the inclusion criteria, 6 cohort and 1 randomized clinical trial. Most of the studies preferred platelet rich fibrin (PRF) and only one used platelet rich plasma (PRP) in MRONJ treatment. MRONJ stage, patients mean age, drug therapy, follow-up and success rate were analysed in all the studies. Five studies also named how MRONJ initiated and 4 studies mentioned duration of drug intake before developing MRONJ.

Conclusion. The published data is not sufficient to confirm a specific treatment protocol although the published results are promising. More prospective randomized controlled clinical trials are required in order to evaluate the effectiveness of APCs for treatment of MRONJ.

Key words: osteonecrosis, medication, platelet, concentrates, surgery.

Received: 06 06 2019

Accepted for publishing: 21 03 2020

¹Department of Oral and Maxillofacial surgery, Lithuanian University of Health Sciences, Kaunas, Lithuania

²Faculty of Odontology, Medical Academy, Lithuanian University of Health Sciences, Kaunas Lithuania

³Department of Dental and Maxillofacial Orthopedics, Lithuanian University of Health Sciences, Kaunas, Lithuania

Address correspondence to Henrikas Rusilas, Department of Oral and Maxillofacial surgery, Lithuanian University of Health Sciences, Sukilėlių pr. 69-19, 49325 Kaunas, Lithuania.

E-mail: henrikas.h@gmail.com



	Baltic Dental and Maxillofacial Journal

March, 2020, Vol. 22, No. 1 CONTENTS SCIENTIFIC ARTICLES Tendencies of FGFR2 rs2981582 polymorphism in patients with oral cancer Vykintas Liutkevicius, Toma Tamauskaite, Alvita Vilkeviciute, Rasa Liutkeviciene, Rasa Smalinskaite, Agne Giedraitiene, Alina Smalinskiene, Virgilijus Uloza 3-8 REVIEWS Basal Cell Carcinoma. Analysis of 395 cases localized in the neck, ear and nose region Egils Kornevs, Ingus Arnolds Apse, Toms Janis Safronovs, Aija Krastina, Arturs Paparde, Gunars Lauskis, Girts Salms 9-16 Sodium hypochlorite accidents in dentistry. A systematic review of published case reports Shishir Ram Shetty, Sura Ali Ahmed Fuoad Al-Bayati, Ashwin Narayanan, Mohammed Said Hamed, Hossam Abdelatty Eid Abdemagyd, Praveen Shetty 17-22 Autologous platelet concentrates in treatment of medication related osteonecrosis of the jaw Henrikas Rusilas, Aušra Balčiūnaitė, Juozas Žilinskas 23-27 CASE REPORT Clear cell odontogenic carcinoma: a rare pathology with an innovative resolution Natalia Lucía Gómez, Luis Boccalatte, Alejandro Yanzón, María Gabriela Nassif, Juan José Larrañaga, Marcelo Fernando Figari 28-32 © 2020 Stomatologija		Stomatologija 2020; 22 (1): 23-7 216 KB Autologous platelet concentrates in treatment of medication related osteonecrosis of the jaw Henrikas Rusilas¹, Aušra Balčiūnaitė², Juozas Žilinskas³ Summary Background. Medication related osteonecrosis of the jaw (MRONJ) is a severe adverse drug reaction occurring as a progressive bone destruction in the maxillofacial region. MRONJ is usually initiated after oral surgery procedures, however periodontal disease and other chronic inflammations are also risk factors. There is no clear treatment protocol for management of MRONJ, for this reason autologous platelet concentrates (APC) have been introduced to enhance the healing process. Aim. To evaluate the effectiveness of APCs in treatment of MRONJ. Methods. A systematic literature review was performed according to PRISMA guidelines in MEDLINE (PubMed) and Google Scholar databases. Only no older than 5 years, in vivo studies in English with follow-up until condition totally resolves were included. Results. A total of 2683 publications were identified out of which only 7 met the inclusion criteria, 6 cohort and 1 randomized clinical trial. Most of the studies preferred platelet rich fibrin (PRF) and only one used platelet rich plasma (PRP) in MRONJ treatment. MRONJ stage, patients mean age, drug therapy, follow-up and success rate were analysed in all the studies. Five studies also named how MRONJ initiated and 4 studies mentioned duration of drug intake before developing MRONJ. Conclusion. The published data is not sufficient to confirm a specific treatment protocol although the published results are promising. More prospective randomized controlled clinical trials are required in order to evaluate the effectiveness of APCs for treatment of MRONJ. Key words: osteonecrosis, medication, platelet, concentrates, surgery. Received: 06 06 2019 Accepted for publishing: 21 03 2020 ¹Department of Oral and Maxillofacial surgery, Lithuanian University of Health Sciences, Kaunas, Lithuania ²Faculty of Odontology, Medical Academy, Lithuanian University of Health Sciences, Kaunas Lithuania ³Department of Dental and Maxillofacial Orthopedics, Lithuanian University of Health Sciences, Kaunas, Lithuania Address correspondence to Henrikas Rusilas, Department of Oral and Maxillofacial surgery, Lithuanian University of Health Sciences, Sukilėlių pr. 69-19, 49325 Kaunas, Lithuania. E-mail: henrikas.h@gmail.com