应用富含生长因子的血浆治疗颌骨药物性骨坏死（MRONJ）术后的三维骨评估：3例报告
Three-dimensional bone evaluation after surgical treatment with plasma rich in growth factors of Medication Related Osteonecrosis of the Jaw (MRONJ): A report of 3 cases.
作者信息
Pardiñas López Simón, Iocca Oreste, Khouly Ismael
机构信息
Periodontology and Oral Surgery, Clínica Médico Dental Pardiñas, Real 66, 3°, 15003 A Coruña, Spain.
Cell Therapy and Regenerative Medicine Group, Centre for Advanced Scientific Research (CICA) and Biomedical Research Institute of A Coruña (INIBIC) strategic group, Universidade da Coruña (UDC), University Hospital Complex of A Coruña (CHUAC), Galician Health Service (SERGAS); A Coruña, Spain.
出版信息
Bone Rep. 2019 May 3;10:100208. doi: 10.1016/j.bonr.2019.100208. eCollection 2019 Jun.
INTRODUCTION
Medication Related Osteonecrosis of the Jaw (MRONJ) is an adverse effect of antiresorptive and antiangiogenic agents that consists of progressive bone destruction in the maxillofacial area. The purpose of this study is to analyze the effect on bone volume of a surgical protocol using plasma rich in growth factors (PRGF) for successfully treating MRONJ.
METHODS
Three patients were treated combining surgical debridement with PRGF. Cone bean computed tomography scans were taken prior to surgery and 12 months after to measure bone volume changes. Biopsies were taken for histology analysis during surgery.
RESULTS
All patients showed a complete soft tissue and bone healing with pain, discomfort, and neural symptoms resolution for a follow up period of 30 months. A total of 12 to 30% of bone volume gain was found at 12 months after surgery.
CONCLUSIONS
PRGF in combination with surgery may be effective in treating MRONJ. Future trials must be performed to confirm these results, including bone volume analysis.
引言
药物性颌骨坏死（MRONJ）是抗吸收和抗血管生成药物的一种不良反应，表现为颌面部进行性骨破坏。本研究的目的是分析使用富含生长因子的血浆（PRGF）的手术方案对成功治疗MRONJ的骨体积的影响。
方法
3例患者接受了手术清创联合PRGF治疗。术前及术后12个月进行锥形束计算机断层扫描以测量骨体积变化。术中取活检进行组织学分析。
结果
所有患者在30个月的随访期内均实现了完全的软组织和骨愈合，疼痛、不适和神经症状均得到缓解。术后12个月发现骨体积增加了12%至30%。
结论
PRGF联合手术可能有效治疗MRONJ。必须进行进一步试验以证实这些结果，包括骨体积分析。
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