Pispero Alberto, Bancora Ivan, Khalil Antonious, Scarnò Dario, Varoni Elena M
Dipartimento di Scienze Biomediche, Chirurgiche ed Odontoiatriche, University of Milan, Via Beldiletto 1, 20142 Milano, Italy.
Biomedicines. 2019 Nov 10;7(4):89. doi: 10.3390/biomedicines7040089.
Tooth extraction in patients treated with bisphosphonates (BPs) for osteoporosis or cancer exposes the patient to the risk of osteonecrosis of the jaw. An autologous membrane using platelet-rich fibrin (PRF) is an innovative technique to promote wound healing, which allows obtaining a hermetic closure of the post-extractive surgical site without the need of mucoperiosteal flaps or periosteal releasing incisions. Here, we report the case of a 70-year-old woman, in therapy with alendronate for 12 years, requiring the upper right premolar extraction because of a crown fracture. After the tooth extraction performed under antiseptic and antibiotic coverage, the PRF autologous membrane was placed on the surgical wound to close completely the post-extraction site. Follow-up visits were carried out after one, two, four weeks and two months from the intervention. The complete re-epithelization of the wound was observed without signs of infection. The use of PRF for the closure of post-extraction sockets in patients taking BPs appears to be a promising alternative to the more invasive surgical procedures. Future clinical trials will be pivotal in elucidating the effectiveness of PRF to prevent BP-related osteonecrosis after tooth extraction.
对于因骨质疏松症或癌症而接受双膦酸盐（BP）治疗的患者，拔牙会使其面临颌骨坏死的风险。使用富血小板纤维蛋白（PRF）的自体膜是一种促进伤口愈合的创新技术，它能够在无需黏膜骨膜瓣或骨膜松解切口的情况下，实现拔牙后手术部位的密闭缝合。在此，我们报告一例70岁女性病例，该患者接受阿仑膦酸钠治疗12年，因冠折需要拔除右上颌前磨牙。在抗菌和抗生素覆盖下进行拔牙后，将PRF自体膜放置在手术伤口上，以完全封闭拔牙部位。在干预后的1周、2周、4周和2个月进行随访。观察到伤口完全重新上皮化，无感染迹象。在服用BP的患者中，使用PRF封闭拔牙窝似乎是一种比更具侵入性的手术方法更有前景的替代方案。未来的临床试验对于阐明PRF预防拔牙后BP相关骨坏死的有效性至关重要。
