Fornaini Carlo, Cella Luigi, Oppici Aldo, Parlatore Anna, Clini Fabio, Fontana Matteo, Lagori Giuseppe, Merigo Elisabetta
Odontostomatology and Maxillo-Facial Surgery Unit - Special care dentistry "Guglielmo da Saliceto" Hospital - Piacenza - Italy.
UFR Odontologie - Université de Nice "Sophia Antipolis" - Nice - France.
Laser Ther. 2017 Sep 30;26(3):223-227. doi: 10.5978/islsm.17-CR-04.
The appropriate management of Medication-Related OsteoNecrosis of the Jaw (MRONJ) is still a challenge for dentists and oral surgeons and in these last years high-technology instruments have been proposed at the different steps of interventions, also combined with promoters of tissue repair.The aim of this report is to show the advantages of a combined approach (laser and PRP) for the treatment of MRONJ.
It is described the case of a patient positive for MRONJ observed at the Odontostomatology and Maxillo-Facial Surgery Unit of the Hospital of Piacenza where surgical approach was performed by using different devices: Er:YAG laser (2940 nm) to remove and vaporize necrotic hard tissue until bleeding bone; Platelet-Rich Plasma (PRP) to stimulate hard and soft tissue healing; diode laser (808 nm) to biostimulate the surgical site.
At the time of suture removal, wound closure was observed and the complete healing of the MRONJ site was observed for the 2 years follow up.
This case may suggest that this kind of combined approach during all the steps of MRONJ treatment allows to perform a faster and less invasive surgery with a more comfortable postoperative healing process and it represents an innovative approach in this severe adverse event.
颌骨药物相关性骨坏死（MRONJ）的恰当管理对牙医和口腔外科医生而言仍是一项挑战，在过去几年中，在干预的不同阶段都有高科技器械被提出，还与组织修复促进剂联合使用。本报告的目的是展示一种联合方法（激光和富血小板血浆[PRP]）治疗MRONJ的优势。
描述了一名在皮亚琴察医院口腔颌面外科发现的MRONJ阳性患者的病例，在该病例中，采用了不同器械进行手术：铒钇铝石榴石（Er:YAG）激光（2940纳米）用于去除和汽化坏死硬组织直至露出出血的骨面；富血小板血浆（PRP）用于刺激硬组织和软组织愈合；二极管激光（808纳米）用于对手术部位进行生物刺激。
在拆除缝线时，观察到伤口闭合，并且在2年的随访中观察到MRONJ部位完全愈合。
该病例可能表明，在MRONJ治疗的所有阶段采用这种联合方法能够进行更快且侵入性更小的手术，术后愈合过程更舒适，并且在这种严重不良事件中代表了一种创新方法。
