Background: The first cases of bisphosphonate-related osteonecrosis of the jaw (BRONJ) were reported in 2003. Since then number of possible treatments have been proposed.
Case report: We report a case of a 50-year-old patient with bisphosphonate-related osteonecrosis of the jaw (BRONJ). The treatment included resection of necrotic bone and the application of plasma rich in growth factors (PRGF®-Endoret®). We closed the ulcer in the soft tissue and the treated bone was regenerated one year later. Finally the regenerated area was rehabilitated with dental implants.
Conclusion: Resection followed by PRGF® -Endoret® was successful in promoting closure of the wound and the recovery of nerve function.
If the inline PDF is not rendering correctly, you can download the PDF file here.
1. Marx RE. Pamidronate (Aredia) and zoledronate (Zometa) induced avascular necrosis of the jaws: a growing epidemic. J Oral Maxillofac Surg 2003; 61:1115-1117.
2. Novince CM Ward BB McCauley LK. Osteonecrosis of the jaw: an update and review of recommendations. Cell Tiss Organ 2009; 189:275-283.
3. European Medicines Agency (EMEA). Committee for Medicinal Products for Human Use (CHMP). EMEA/CHMP assessment report on bisphosphonates and osteonecrosis of the jaw. EMEA/CHMP/291125/2009.
4. Otto S Hafner S Grotz KA. The role of inferior alveolar nerve involvement in bisphosphonate-related osteonecrosis of the jaw. J Oral Maxillofac Surg 2009; 67:589-592.
5. Yu W Wang J Yin J. Platelet-rich plasma: a promising product for treatment of peripheral nerve regeneration after nerve injury. Int J Neurosci 2011; 121:176-180.
6. Anitua E Prado R Orive G. A lateral approach for sinus elevation using PRGF technology. Clin Implant Dent Relat Res 2009; 11:e23-e31.
7. Freiberger JJ Feldmeier JJ. Evidence supporting the use of hyperbaric oxygen in the treatment of osteoradionecrosis of the jaw. J Oral Maxillofac Surg 2010; 68:1903-1906.
8. Ruggiero SL Dodson TB Assael LA Landesberg R Marx RE Mehrotra B. American Association of Oral and Maxillofacial Surgeons position paper on bisphosphonate-related osteonecrosis of the jaws—2009 update. J Oral Maxillofac Surg 2009; 67:2-12.
9. 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; 48:469-474.
10. Mozzati M Arata V Gallesio G. Tooth extraction in patients on zoledronicacid therapy. Oral Oncol 2012; 48:817-821.
11. Anitua E Zalduendo M Troya M Orive G. PRGF exerts a cytoprotective role in zoledronic acid-treated oral cells. Clin Oral Investig 2016;20 :513-521.