Department of Clinical Physiopathology, University of Turin, Turin, Italy.
Oral Oncol. 2012 May;48(5):469-74. doi: 10.1016/j.oraloncology.2011.12.004. Epub 2012 Jan 20.
Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is an important complication in cancer patients taking intravenous BPs (BPs). In most cases, BRONJ is associated with an oral surgery procedure involving jaw bone. Currently, BRONJ management remains controversial, and there is no definitive standard of care for this disease. In fact, several articles in the recent literature discuss treatments that range from topical to surgical treatment, without definitive conclusion about treatment. A clinical study was conducted on 32 patients treated with i.v BPs for oncologic pathologies affected by BRONJ. The patients were treated by resection of the necrotic bone with primary closure of the mucosa over the bony defect using plasma rich in growth factors (PRGF). Orthopanoramic and computed tomography were performed before and after surgery. No intraoperative complications were observed, and all 32 cases were treated successfully. Our data on the use of PRGF demonstrate positive results for this surgical treatment. PRGF may enhance vascularization and regeneration of osseous and epithelial tissues.
颌骨骨坏死（BRONJ）是接受静脉注射双膦酸盐（BPs）的癌症患者的一种重要并发症。在大多数情况下，BRONJ 与涉及颌骨的口腔手术程序有关。目前，BRONJ 的治疗仍然存在争议，并且针对这种疾病尚无明确的护理标准。实际上，最近的文献中有几篇文章讨论了从局部治疗到手术治疗的各种治疗方法，但对于治疗方法并没有明确的结论。对 32 例因 BRONJ 而接受静脉注射 BPs 治疗的肿瘤患者进行了一项临床研究。对这些患者进行了手术治疗，切除坏死的骨，并用富含生长因子的富血小板纤维蛋白（PRGF）覆盖在骨缺损上的粘膜进行一期闭合。在手术前后进行了 orthopanoramic 和计算机断层扫描。未观察到术中并发症，所有 32 例均成功治疗。我们使用 PRGF 的数据表明这种手术治疗的结果是积极的。PRGF 可能增强血管生成和骨组织和上皮组织的再生。
