Department of Clinical Physiopathology, Oral Surgery Unit, Dentistry Section, University of Turin, Turin 10126, Italy.
Oral Oncol. 2012 Sep;48(9):817-21. doi: 10.1016/j.oraloncology.2012.03.009. Epub 2012 Apr 5.
Surgical management of patients following zoledronic acid therapy is particularly difficult, since the dental extraction is the main cause of BRONJ.
A case-control study was conducted on 176 patients treated with intravenous (IV) bisphosphonates for oncologic pathologies who also underwent dental extractions. The study was divided randomly into two groups: 91 were treated with Plasma Rich in Growth Factor Plasma (PRGF) (study group) and the other 85 were not treated with the growth factor preparation (control group).
Panoramic X-ray and computed tomography were performed both before and 60 months after surgery. By clinical and radiological diagnosis, BRONJ was diagnosed in only 5 patients in the control group at an average of 91, 6 days after tooth extraction.
We hypothesize that Plasma Rich in Growth Factor (PRGF) is important for the successful treatment of patients on bisphosphonates to restore the osteoblast/osteoclast homeostatic cycles via autologous cytokines. Moreover, this protocol reduces the risk of BRONJ when it is necessary to perform dental extractions in patients undergoing IV bisphosphonate treatment.
接受唑来膦酸治疗的患者的手术管理尤其困难，因为拔牙是导致 BRONJ 的主要原因。
对 176 例因肿瘤疾病接受静脉（IV）双膦酸盐治疗且同时进行拔牙的患者进行了病例对照研究。该研究随机分为两组：91 例患者接受富含生长因子的血浆（PRGF）治疗（研究组），另 85 例患者未接受生长因子制剂治疗（对照组）。
手术前和手术后 60 个月均进行全景 X 线和计算机断层扫描。通过临床和放射学诊断，仅在对照组的 5 例患者中诊断出 BRONJ，拔牙后平均 91.6 天。
我们假设富含生长因子的血浆（PRGF）对于成功治疗接受双膦酸盐治疗的患者很重要，通过自体细胞因子恢复成骨细胞/破骨细胞的动态平衡。此外，当需要对接受 IV 双膦酸盐治疗的患者进行拔牙时，该方案可降低 BRONJ 的风险。
