Non-Interventional Prospective Observational Study of Platelet Rich Fibrin as a Therapy Adjunctive in Patients with Medication-Related Osteonecrosis of the Jaw

Medication-related osteonecrosis (MRONJ) of the jaw is a severe and feared side effect of antiresorptive therapy in the oncological setting. With growing evidence that impaired angiogenesis may represent a key factor in pathogenesis, the aim of this study was to evaluate an autologous platelet conce...

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Bibliographic Details
Published in:Journal of clinical medicine 2022-01, Vol.11 (3), p.682
Main Authors: Blatt, Sebastian, Krüger, Maximilian, Kämmerer, Peer W, Thiem, Daniel G E, Matheis, Philipp, Eisenbeiß, Anne-Katrin, Wiltfang, Jörg, Al-Nawas, Bilal, Naujokat, Hendrik
Format: Article
Language:English
Subjects:
Angiogenesis
Antibiotics
Bisphosphonates
Blood platelets
Clinical medicine
Clinical trials
Consent
Disease
Enteral nutrition
Fibroblasts
Maxillofacial surgery
Metastasis
Observational studies
Osteoporosis
Pain
Patients
Quality of life
Wound healing
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Summary:Medication-related osteonecrosis (MRONJ) of the jaw is a severe and feared side effect of antiresorptive therapy in the oncological setting. With growing evidence that impaired angiogenesis may represent a key factor in pathogenesis, the aim of this study was to evaluate an autologous platelet concentrate as a possible additive in surgical therapy to optimize vascularization and, subsequently, resolution rates. A non-interventional, prospective, multicenter study was conducted, and all patients with stage I-III MRONJ, undergoing antiresorptive therapy for an oncological indication, were included. The necrosis was treated surgically without (study arm A) or with (arm B) the addition of an autologous platelet concentrate (platelet-rich fibrin, PRF). After 5, 14, and 42 days postoperative, wound healing (primary outcome: mucosal integrity) as well as downstaging, pain perception, and oral health-related quality of life (secondary outcome) were assessed via clinical evaluation. Among the 52 patients included, primarily with MRONJ stage I and II, the use of PRF as an additive in surgical therapy did not display a significant advantage for wound healing ( = 0.302), downstaging ( = 0.9), pain reduction ( = 0.169), or quality of life ( = 0.9). In conclusion, PRF as an adjunct did not significantly optimize wound healing. Further, no significant changes in terms of downstaging, pain sensation, and oral health-related quality of life were found.
ISSN:2077-0383
2077-0383
DOI:10.3390/jcm11030682