Effectiveness of Leukocyte- and Platelet-rich Fibrin in the Management of Medication-related Osteonecrosis of the Jaws – A Systematic Review
Abstract
Background: Medication-related osteonecrosis of the jaw (MRONJ) is a rare, but significant adverse event primarily associated with the intake of antiresorptive and antiangiogenic medications. Although antiresorptive and antiangiogenic the-rapies improve life expectancy, particularly in cancer patients, MRONJ may hamper the patient’s quality of life due to pain, discomfort, anxiety, depression, speech impairment, difficulty in swallowing and eating, frequent medical and dental evaluations and treatments, and the possibility of treatment discontinuation. Leukocyte– and Platelet-rich Fibrin (L-PRF) is an autologous platelet aggregate that promotes wound healing by stimulating re-epithelialization, angiogenesis, and extracellular matrix production. Aim: The present systematic review aimed to compare the results in the published literature on whether L-PRF is an effective and predictable adjuvant to surgical debridement of necrotic bone for improving the healing efficacy in patients with MRONJ.
Materials and Methods: The PubMed, Scopus, Cochrane, Science Direct, LILACS, and Web of Science databases were searched using the predetermined MeSH terms and eligibility criteria, and the search yielded a total of five articles. Two studies were retrospective, and three studies were case series.
Results: Seventeen participants received a combination of surgical debridement, L-PRF membrane, and antibiotics. Complete wound healing was observed in 70% of the participants, and most of them healed without any complications.
Conclusions: L-PRF as an adjuvant to surgical debridement of necrosed bone appears to have a positive association with the healing outcome in patients with MRONJ.
Keywords: Jaw; Osteonecrosis; Bisphosphonate-Associated Osteonecrosis of the Jaw; Wound healing; Guided tissue regeneration; Platelet-rich Fibrin.
References
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5. Tenore G, Mohsen A, Rossi AF, Palaia G, Rocchetti F, Cassoni A, Valentini V, Ottolenghi L, Polimeni A, Romeo U. Does Medication-Related Osteonecrosis of the Jaw Influence the Quality of Life of Cancer Patients? Biomedicines. 2020;8(4):95. doi: 10.3390/biomedicines8040095. PMID: 32344782; PMCID: PMC7235831.
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7. Dragonas P, Katsaros T, Avila-Ortiz G, Chambrone L, Schiavo JH, Palaiologou A. Effects of leukocyte-platelet-rich fibrin (L-PRF) in different intraoral bone grafting procedures: a systematic review. Int J Oral Maxillofac Surg. 2019;48(2):250-262. doi: 10.1016/j.ijom.2018.06.003. Epub 2018 Jul 7. PMID: 30058532.
8. Dohan DM, Choukroun J, Diss A, Dohan SL, Dohan AJ, Mouhyi J, Gogly B. Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part I: technological concepts and evolution. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006;101(3):e37-44. doi: 10.1016/j.tripleo.2005.07.008. Epub 2006 Jan 19. PMID: 16504849.
9. Dohan Ehrenfest DM, Del Corso M, Diss A, Mouhyi J, Charrier JB. Three-dimensional architecture and cell composition of a Choukroun’s platelet-rich fibrin clot and membrane. J Periodontol. 2010;81(4):546-55. doi: 10.1902/jop.2009.090531. PMID: 20373539.
10. Saluja H, Dehane V, Mahindra U. Platelet-Rich fibrin: A second generation platelet concentrate and a new friend of oral and maxillofacial surgeons. Ann Maxillofac Surg. 2011;1(1):53-7. doi: 10.4103/2231-0746.83158. PMID: 23482459; PMCID: PMC3591032.
11. Tsirogianni AK, Moutsopoulos NM, Moutsopoulos HM. Wound healing: immunological aspects. Injury. 2006;37 Suppl 1:S5-12. doi: 10.1016/j.injury.2006.02.035. Epub 2006 Apr 17. PMID: 16616753.
12. Kobayashi E, Flückiger L, Fujioka-Kobayashi M, Sawada K, Sculean A, Schaller B, Miron RJ. Comparative release of growth factors from PRP, PRF, and advanced-PRF. Clin Oral Investig. 2016 ;20(9):2353-2360. doi: 10.1007/s00784-016-1719-1. Epub 2016 Jan 25. PMID: 26809431.
13. Miron RJ, Fujioka-Kobayashi M, Bishara M, Zhang Y, Hernandez M, Choukroun J. Platelet-Rich Fibrin and Soft Tissue Wound Healing: A Systematic Review. Tissue Eng Part B Rev. 2017;23(1):83-99. doi: 10.1089/ten.TEB.2016.0233. Epub 2016 Oct 10. PMID: 27672729.
14. Tricco AC, Lillie E, Zarin W, O’Brien KK, Colquhoun H, Levac D, Moher D, Peters MDJ, Horsley T, Weeks L, Hempel S, Akl EA, Chang C, McGowan J, Stewart L, Hartling L, Aldcroft A, Wilson MG, Garritty C, Lewin S, Godfrey CM, Macdonald MT, Langlois EV, Soares-Weiser K, Moriarty J, Clifford T, Tunçalp Ö, Straus SE. PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation. Ann Intern Med. 2018;169(7):467-473. doi: 10.7326/M18-0850. Epub 2018 Sep 4. PMID: 30178033.
15. Murad MH, Sultan S, Haffar S, Bazerbachi F. Methodological quality and synthesis of case series and case reports. BMJ Evid Based Med. 2018;23(2):60-63. doi: 10.1136/bmjebm-2017-110853. Epub 2018 Feb 2. PMID: 29420178; PMCID: PMC6234235.
16. Bero L, Chartres N, Diong J, Fabbri A, Ghersi D, Lam J, Lau A, McDonald S, Mintzes B, Sutton P, Turton JL, Woodruff TJ. The risk of bias in observational studies of exposures (ROBINS-E) tool: concerns arising from application to observational studies of exposures. Syst Rev. 2018;7(1):242. doi: 10.1186/s13643-018-0915-2. PMID: 30577874; PMCID: PMC6302384.
17. Agency for Healthcare Research and Quality (AHRQ).. Available from: https://www.ahrq.gov/
18. Maluf G, Caldas RJ, Silva Santos PS. Use of Leukocyte- and Platelet-Rich Fibrin in the Treatment of Medication-Related Osteonecrosis of the Jaws. J Oral Maxillofac Surg. 2018; 76(1):88-96. doi: 10.1016/j.joms.2017.06.004. Epub 2017 Jun 12. PMID: 28675810.
19.Maluf G, Pinho MC, Cunha SR, Santos PS, Fregnani ER. Surgery Combined with LPRF in Denosumab Osteonecrosis of the Jaw: Case Report. Braz Dent J. 2016;27(3):353-8. doi: 10.1590/0103-6440201600662. PMID: 27224573.
20.Valente NA, Chatelain S, Alfonsi F, Mortellaro C, Barone A. Medication-Related Osteonecrosis of the Jaw: The Use of Leukocyte-Platelet-Rich Fibrin as an Adjunct in the Treatment. J Craniofac Surg. 2019;30(4):1095-1101. doi: 10.1097/SCS.0000000000005475. PMID: 30908443.
21. Özalp Ö, Yıldırımyan N, Öztürk C, Kocabalkan B, Şimşek Kaya G, Sindel A, Altay MA. Promising results of surgical management of advanced medication related osteonecrosis of the jaws using adjunctive leukocyte and platelet rich fibrin. BMC Oral Health. 2021;21(1):613. doi: 10.1186/s12903-021-01965-7. PMID: 34852823; PMCID: PMC8638116.
22. Bouland C, Meuleman N, Widelec J, Keiani-Mothlagh K, Voisin C, Lagneaux L, Philippart P. Case reports of medication-related osteonecrosis of the jaw (MRONJ) treated with uncultured stromal vascular fraction and L-PRF. J Stomatol Oral Maxillofac Surg. 2021;122(2):212-218. doi: 10.1016/j.jormas.2020.05.024. Epub 2020 Jun 12. PMID: 32540361.
23. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, Shamseer L, Tetzlaff JM, Akl EA, Brennan SE, Chou R, Glanville J, Grimshaw JM, Hróbjartsson A, Lalu MM, Li T, Loder EW, Mayo-Wilson E, McDonald S, McGuinness LA, Stewart LA, Thomas J, Tricco AC, Welch VA, Whiting P, Moher D. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372:n71. doi: 10.1136/bmj.n71. PMID: 33782057; PMCID: PMC8005924.
24. Mozzati M, Gallesio G, Arata V, Pol R, Scoletta M. Platelet-rich therapies in the treatment of intravenous bisphosphonate-related osteonecrosis of the jaw: a report of 32 cases. Oral Oncol. 2012;48(5):469-74. doi: 10.1016/j.oraloncology.2011.12.004.
25. Dohan Ehrenfest DM, Rasmusson L, Albrektsson T. Classification of platelet concentrates: from pure platelet-rich plasma (P-PRP) to leucocyte- and platelet-rich fibrin (L-PRF). Trends Biotechnol. 2009;27(3):158-67. doi: 10.1016/j.tibtech.2008.11.009. Epub 2009 Jan 31. PMID: 19187989.
26. Dohan Ehrenfest DM, Pinto NR, Pereda A, Jiménez P, Corso MD, Kang BS, Nally M, Lanata N, Wang HL, Quirynen M. The impact of the centrifuge characteristics and centrifugation protocols on the cells, growth factors, and fibrin architecture of a leukocyte- and platelet-rich fibrin (L-PRF) clot and membrane. Platelets. 2018;29(2):171-184. doi: 10.1080/09537104.2017.1293812. Epub 2017 Apr 24. PMID: 28437133.
27. Kang MH, Lee DK, Kim CW, Song IS, Jun SH. Clinical characteristics and recurrence-related factors of medication-related osteonecrosis of the jaw. J Korean Assoc Oral Maxillofac Surg. 2018 Oct;44(5):225-231. doi: 10.5125/jkaoms.2018.44.5.225. Epub 2018 Oct 26. Erratum in: J Korean Assoc Oral Maxillofac Surg. 2018;44(6):302. doi: 10.5125/jkaoms.2018.44.6.302. PMID: 30402414; PMCID: PMC6209697.
28. Chang HJ, Kim MJ, Ahn KM. Associated systemic diseases and etiologies of medication-related osteonecrosis of the jaw: a retrospective study of 265 surgical cases. Maxillofac Plast Reconstr Surg. 2023;45(1):12. doi: 10.1186/s40902-023-00377-7. PMID: 36853370; PMCID: PMC9975129.
29. Anastasilakis AD, Polyzos SA, Makras P. THERAPY OF ENDOCRINE DISEASE: Denosumab vs bisphosphonates for the treatment of postmenopausal osteoporosis. Eur J Endocrinol. 2018;179(1):R31-R45. doi: 10.1530/EJE-18-0056. Epub 2018 Apr 24. PMID: 29691303.
30. Wat WZM. Current Controversies on the Pathogenesis of Medication-Related Osteonecrosis of the Jaw. Dent J (Basel). 2016;4(4):38. doi: 10.3390/dj4040038. PMID: 29563480; PMCID: PMC5806951.
31. Bagan J, Scully C, Sabater V, Jimenez Y. Osteonecrosis of the jaws in patients treated with intravenous bisphosphonates (BRONJ): A concise update. Oral Oncol. 2009;45(7):551-4. doi: 10.1016/j.oraloncology.2009.01.002. Epub 2009 Feb 28. PMID: 19251474.
32. Ciobanu GA, Mogoantă L, Camen A, Ionescu M, Vlad D, Staicu IE, Munteanu CM, Gheorghiță MI, Mercuț R, Sin EC, Popescu SM. Clinical and Histopathological Aspects of MRONJ in Cancer Patients. J Clin Med. 2023;12(10):3383. doi: 10.3390/jcm12103383. PMID: 37240491; PMCID: PMC10219482.
33. Sacco R, Woolley J, Yates J, Calasans-Maia MD, Akintola O, Patel V. The role of antiresorptive drugs and medication-related osteonecrosis of the jaw in nononcologic immunosuppressed patients: A systematic review. J Res Med Sci. 2021;26:23. doi: 10.4103/jrms.JRMS_794_20. PMID: 34221052; PMCID: PMC8240545.
34. Park JH, Kim JW, Kim SJ. Does the Addition of Bone Morphogenetic Protein 2 to Platelet-Rich Fibrin Improve Healing After Treatment for Medication-Related Osteonecrosis of the Jaw? J Oral Maxillofac Surg. 2017;75(6):1176-1184. doi: 10.1016/j.joms.2016.12.005. Epub 2016 Dec 11. PMID: 28042979.
2. He L, Sun X, Liu Z, Qiu Y, Niu Y. Pathogenesis and multidisciplinary management of medication-related osteonecrosis of the jaw. Int J Oral Sci. 2020;12(1):30. doi: 10.1038/s41368-020-00093-2. PMID: 33087699; PMCID: PMC7578793.
3. Lo JC, O’Ryan FS, Gordon NP, Yang J, Hui RL, Martin D, Hutchinson M, Lathon PV, Sanchez G, Silver P, Chandra M, McCloskey CA, Staffa JA, Willy M, Selby JV, Go AS; Predicting Risk of Osteonecrosis of the Jaw with Oral Bisphosphonate Exposure (PROBE) Investigators. Prevalence of osteonecrosis of the jaw in patients with oral bisphosphonate exposure. J Oral Maxillofac Surg. 2010;68(2):243-53. doi: 10.1016/j.joms.2009.03.050. Epub 2009 Sep 24. PMID: 19772941; PMCID: PMC10159647.
4. Lo JC, O’Ryan FS, Gordon NP, Yang J, Hui RL, Martin D, Hutchinson M, Lathon PV, Sanchez G, Silver P, Chandra M, McCloskey CA, Staffa JA, Willy M, Selby JV, Go AS; Predicting Risk of Osteonecrosis of the Jaw with Oral Bisphosphonate Exposure (PROBE) Investigators. Prevalence of osteonecrosis of the jaw in patients with oral bisphosphonate exposure. J Oral Maxillofac Surg. 2010;68(2):243-53. doi: 10.1016/j.joms.2009.03.050. Epub 2009 Sep 24. PMID: 19772941; PMCID: PMC10159647.
5. Tenore G, Mohsen A, Rossi AF, Palaia G, Rocchetti F, Cassoni A, Valentini V, Ottolenghi L, Polimeni A, Romeo U. Does Medication-Related Osteonecrosis of the Jaw Influence the Quality of Life of Cancer Patients? Biomedicines. 2020;8(4):95. doi: 10.3390/biomedicines8040095. PMID: 32344782; PMCID: PMC7235831.
6. On SW, Cho SW, Byun SH, Yang BE. Various Therapeutic Methods for the Treatment of Medication-Related Osteonecrosis of the Jaw (MRONJ) and Their Limitations: A Narrative Review on New Molecular and Cellular Therapeutic Approaches. Antioxidants (Basel). 2021;10(5):680. doi: 10.3390/antiox10050680. PMID: 33925361; PMCID: PMC8145192.
7. Dragonas P, Katsaros T, Avila-Ortiz G, Chambrone L, Schiavo JH, Palaiologou A. Effects of leukocyte-platelet-rich fibrin (L-PRF) in different intraoral bone grafting procedures: a systematic review. Int J Oral Maxillofac Surg. 2019;48(2):250-262. doi: 10.1016/j.ijom.2018.06.003. Epub 2018 Jul 7. PMID: 30058532.
8. Dohan DM, Choukroun J, Diss A, Dohan SL, Dohan AJ, Mouhyi J, Gogly B. Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part I: technological concepts and evolution. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006;101(3):e37-44. doi: 10.1016/j.tripleo.2005.07.008. Epub 2006 Jan 19. PMID: 16504849.
9. Dohan Ehrenfest DM, Del Corso M, Diss A, Mouhyi J, Charrier JB. Three-dimensional architecture and cell composition of a Choukroun’s platelet-rich fibrin clot and membrane. J Periodontol. 2010;81(4):546-55. doi: 10.1902/jop.2009.090531. PMID: 20373539.
10. Saluja H, Dehane V, Mahindra U. Platelet-Rich fibrin: A second generation platelet concentrate and a new friend of oral and maxillofacial surgeons. Ann Maxillofac Surg. 2011;1(1):53-7. doi: 10.4103/2231-0746.83158. PMID: 23482459; PMCID: PMC3591032.
11. Tsirogianni AK, Moutsopoulos NM, Moutsopoulos HM. Wound healing: immunological aspects. Injury. 2006;37 Suppl 1:S5-12. doi: 10.1016/j.injury.2006.02.035. Epub 2006 Apr 17. PMID: 16616753.
12. Kobayashi E, Flückiger L, Fujioka-Kobayashi M, Sawada K, Sculean A, Schaller B, Miron RJ. Comparative release of growth factors from PRP, PRF, and advanced-PRF. Clin Oral Investig. 2016 ;20(9):2353-2360. doi: 10.1007/s00784-016-1719-1. Epub 2016 Jan 25. PMID: 26809431.
13. Miron RJ, Fujioka-Kobayashi M, Bishara M, Zhang Y, Hernandez M, Choukroun J. Platelet-Rich Fibrin and Soft Tissue Wound Healing: A Systematic Review. Tissue Eng Part B Rev. 2017;23(1):83-99. doi: 10.1089/ten.TEB.2016.0233. Epub 2016 Oct 10. PMID: 27672729.
14. Tricco AC, Lillie E, Zarin W, O’Brien KK, Colquhoun H, Levac D, Moher D, Peters MDJ, Horsley T, Weeks L, Hempel S, Akl EA, Chang C, McGowan J, Stewart L, Hartling L, Aldcroft A, Wilson MG, Garritty C, Lewin S, Godfrey CM, Macdonald MT, Langlois EV, Soares-Weiser K, Moriarty J, Clifford T, Tunçalp Ö, Straus SE. PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation. Ann Intern Med. 2018;169(7):467-473. doi: 10.7326/M18-0850. Epub 2018 Sep 4. PMID: 30178033.
15. Murad MH, Sultan S, Haffar S, Bazerbachi F. Methodological quality and synthesis of case series and case reports. BMJ Evid Based Med. 2018;23(2):60-63. doi: 10.1136/bmjebm-2017-110853. Epub 2018 Feb 2. PMID: 29420178; PMCID: PMC6234235.
16. Bero L, Chartres N, Diong J, Fabbri A, Ghersi D, Lam J, Lau A, McDonald S, Mintzes B, Sutton P, Turton JL, Woodruff TJ. The risk of bias in observational studies of exposures (ROBINS-E) tool: concerns arising from application to observational studies of exposures. Syst Rev. 2018;7(1):242. doi: 10.1186/s13643-018-0915-2. PMID: 30577874; PMCID: PMC6302384.
17. Agency for Healthcare Research and Quality (AHRQ).. Available from: https://www.ahrq.gov/
18. Maluf G, Caldas RJ, Silva Santos PS. Use of Leukocyte- and Platelet-Rich Fibrin in the Treatment of Medication-Related Osteonecrosis of the Jaws. J Oral Maxillofac Surg. 2018; 76(1):88-96. doi: 10.1016/j.joms.2017.06.004. Epub 2017 Jun 12. PMID: 28675810.
19.Maluf G, Pinho MC, Cunha SR, Santos PS, Fregnani ER. Surgery Combined with LPRF in Denosumab Osteonecrosis of the Jaw: Case Report. Braz Dent J. 2016;27(3):353-8. doi: 10.1590/0103-6440201600662. PMID: 27224573.
20.Valente NA, Chatelain S, Alfonsi F, Mortellaro C, Barone A. Medication-Related Osteonecrosis of the Jaw: The Use of Leukocyte-Platelet-Rich Fibrin as an Adjunct in the Treatment. J Craniofac Surg. 2019;30(4):1095-1101. doi: 10.1097/SCS.0000000000005475. PMID: 30908443.
21. Özalp Ö, Yıldırımyan N, Öztürk C, Kocabalkan B, Şimşek Kaya G, Sindel A, Altay MA. Promising results of surgical management of advanced medication related osteonecrosis of the jaws using adjunctive leukocyte and platelet rich fibrin. BMC Oral Health. 2021;21(1):613. doi: 10.1186/s12903-021-01965-7. PMID: 34852823; PMCID: PMC8638116.
22. Bouland C, Meuleman N, Widelec J, Keiani-Mothlagh K, Voisin C, Lagneaux L, Philippart P. Case reports of medication-related osteonecrosis of the jaw (MRONJ) treated with uncultured stromal vascular fraction and L-PRF. J Stomatol Oral Maxillofac Surg. 2021;122(2):212-218. doi: 10.1016/j.jormas.2020.05.024. Epub 2020 Jun 12. PMID: 32540361.
23. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, Shamseer L, Tetzlaff JM, Akl EA, Brennan SE, Chou R, Glanville J, Grimshaw JM, Hróbjartsson A, Lalu MM, Li T, Loder EW, Mayo-Wilson E, McDonald S, McGuinness LA, Stewart LA, Thomas J, Tricco AC, Welch VA, Whiting P, Moher D. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372:n71. doi: 10.1136/bmj.n71. PMID: 33782057; PMCID: PMC8005924.
24. Mozzati M, Gallesio G, Arata V, Pol R, Scoletta M. Platelet-rich therapies in the treatment of intravenous bisphosphonate-related osteonecrosis of the jaw: a report of 32 cases. Oral Oncol. 2012;48(5):469-74. doi: 10.1016/j.oraloncology.2011.12.004.
25. Dohan Ehrenfest DM, Rasmusson L, Albrektsson T. Classification of platelet concentrates: from pure platelet-rich plasma (P-PRP) to leucocyte- and platelet-rich fibrin (L-PRF). Trends Biotechnol. 2009;27(3):158-67. doi: 10.1016/j.tibtech.2008.11.009. Epub 2009 Jan 31. PMID: 19187989.
26. Dohan Ehrenfest DM, Pinto NR, Pereda A, Jiménez P, Corso MD, Kang BS, Nally M, Lanata N, Wang HL, Quirynen M. The impact of the centrifuge characteristics and centrifugation protocols on the cells, growth factors, and fibrin architecture of a leukocyte- and platelet-rich fibrin (L-PRF) clot and membrane. Platelets. 2018;29(2):171-184. doi: 10.1080/09537104.2017.1293812. Epub 2017 Apr 24. PMID: 28437133.
27. Kang MH, Lee DK, Kim CW, Song IS, Jun SH. Clinical characteristics and recurrence-related factors of medication-related osteonecrosis of the jaw. J Korean Assoc Oral Maxillofac Surg. 2018 Oct;44(5):225-231. doi: 10.5125/jkaoms.2018.44.5.225. Epub 2018 Oct 26. Erratum in: J Korean Assoc Oral Maxillofac Surg. 2018;44(6):302. doi: 10.5125/jkaoms.2018.44.6.302. PMID: 30402414; PMCID: PMC6209697.
28. Chang HJ, Kim MJ, Ahn KM. Associated systemic diseases and etiologies of medication-related osteonecrosis of the jaw: a retrospective study of 265 surgical cases. Maxillofac Plast Reconstr Surg. 2023;45(1):12. doi: 10.1186/s40902-023-00377-7. PMID: 36853370; PMCID: PMC9975129.
29. Anastasilakis AD, Polyzos SA, Makras P. THERAPY OF ENDOCRINE DISEASE: Denosumab vs bisphosphonates for the treatment of postmenopausal osteoporosis. Eur J Endocrinol. 2018;179(1):R31-R45. doi: 10.1530/EJE-18-0056. Epub 2018 Apr 24. PMID: 29691303.
30. Wat WZM. Current Controversies on the Pathogenesis of Medication-Related Osteonecrosis of the Jaw. Dent J (Basel). 2016;4(4):38. doi: 10.3390/dj4040038. PMID: 29563480; PMCID: PMC5806951.
31. Bagan J, Scully C, Sabater V, Jimenez Y. Osteonecrosis of the jaws in patients treated with intravenous bisphosphonates (BRONJ): A concise update. Oral Oncol. 2009;45(7):551-4. doi: 10.1016/j.oraloncology.2009.01.002. Epub 2009 Feb 28. PMID: 19251474.
32. Ciobanu GA, Mogoantă L, Camen A, Ionescu M, Vlad D, Staicu IE, Munteanu CM, Gheorghiță MI, Mercuț R, Sin EC, Popescu SM. Clinical and Histopathological Aspects of MRONJ in Cancer Patients. J Clin Med. 2023;12(10):3383. doi: 10.3390/jcm12103383. PMID: 37240491; PMCID: PMC10219482.
33. Sacco R, Woolley J, Yates J, Calasans-Maia MD, Akintola O, Patel V. The role of antiresorptive drugs and medication-related osteonecrosis of the jaw in nononcologic immunosuppressed patients: A systematic review. J Res Med Sci. 2021;26:23. doi: 10.4103/jrms.JRMS_794_20. PMID: 34221052; PMCID: PMC8240545.
34. Park JH, Kim JW, Kim SJ. Does the Addition of Bone Morphogenetic Protein 2 to Platelet-Rich Fibrin Improve Healing After Treatment for Medication-Related Osteonecrosis of the Jaw? J Oral Maxillofac Surg. 2017;75(6):1176-1184. doi: 10.1016/j.joms.2016.12.005. Epub 2016 Dec 11. PMID: 28042979.
Published
2024-07-17
How to Cite
MOHANDAS, Rahul et al.
Effectiveness of Leukocyte- and Platelet-rich Fibrin in the Management of Medication-related Osteonecrosis of the Jaws – A Systematic Review.
Journal of Oral Research, [S.l.], v. 13, n. 1, p. 170-180, july 2024.
ISSN 0719-2479.
Available at: <https://joralres.com/index.php/JOralRes/article/view/joralres.2024.015>. Date accessed: 22 july 2024.
doi: https://doi.org/10.17126/joralres.2024.015.
Section
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