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富血小板纤维蛋白在药物相关性颌骨坏死中的应用:一项病例系列研究。

The use of Platelet-rich Fibrin in the management of medication-related osteonecrosis of the jaw: A case series.

机构信息

Department of Molecular and Cell Biology, Institute of Biology, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil; Department of Oral Surgery, Dentistry School, Estácio de Sá University, Rio de Janeiro, Brazil; Department of Oral Surgery, Dentistry School, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil.

Department of Oral Surgery, Dentistry School, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil.

出版信息

J Stomatol Oral Maxillofac Surg. 2020 Feb;121(1):84-89. doi: 10.1016/j.jormas.2019.02.011. Epub 2019 Feb 20.

Abstract

Medication related osteonecrosis of the jaw (MRONJ) is characterized by exposed necrotic bone in the maxillofacial region that persists for more than eight weeks in patients taking antiresorptive or antiangiogenic drugs for bone metastasis or osteoporosis. The management of such condition depends on several factors, among which the staging of MRONJ. Though, a specific gold standard treatment has not been established to date. The aim of this case series is to describe the outcome of surgical treatment of MRONJ with the adjunct of Platelet-rich Fibrin (PRF). Eleven patients under therapy with alendronate underwent surgical removal of necrotic bone and debridement, followed by placement of PRF membranes in the bone defect. The outcome of the surgical treatment was successful in all patients, in a follow-up range from 12 to 36 months. In the cases presented, the macroscopic evaluation showed excellent and fast soft tissue healing, with no recurrence of bone exposure and no signs of infections. PRF membranes were also effective for postsurgical pain control. The use of PRF may represent a valuable adjunct in the surgical management of MRONJ.

摘要

药物相关性颌骨坏死(MRONJ)的特征是在接受抗吸收或抗血管生成药物治疗骨转移或骨质疏松症的患者中,颌面部出现持续超过 8 周的暴露性坏死骨。这种情况的治疗取决于几个因素,其中包括 MRONJ 的分期。尽管如此,迄今为止尚未建立特定的金标准治疗方法。本病例系列的目的是描述使用富含血小板纤维蛋白(PRF)辅助治疗 MRONJ 的手术治疗结果。11 名接受阿伦膦酸盐治疗的患者接受了坏死骨切除术和清创术,随后在骨缺损处放置 PRF 膜。在 12 至 36 个月的随访中,所有患者的手术治疗结果均成功。在报告的病例中,宏观评估显示软组织愈合良好且快速,无骨暴露复发和感染迹象。PRF 膜也可有效控制术后疼痛。PRF 的使用可能是 MRONJ 手术治疗的一种有价值的辅助手段。

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