Adamska Paulina, Stasiak Marcin, Kobusińska Natalia, Bartmański Michał, Zedler Adam, Studniarek Michał
Division of Oral Surgery, Medical University of Gdańsk, 7 Dębinki Street, 80-211 Gdańsk, Poland.
Division of Orthodontics, Faculty of Medicine, Medical University of Gdańsk, 42c Aleja Zwycięstwa, 80-210 Gdańsk, Poland.
J Funct Biomater. 2025 May 14;16(5):180. doi: 10.3390/jfb16050180.
Medication-related osteonecrosis of the jaw (MRONJ) is drug-induced bone destruction that is exposed for a minimum of 6 to 8 weeks in patients who have not received head and neck radiotherapy and who have not been diagnosed with facial bone metastases. MRONJ treatment outcomes are unpredictable. Therefore, alternative treatment methods are being explored, such as blood-derived platelet-rich preparations enriched with growth factors, including advanced platelet-rich fibrin (A-PRF). The presence of growth factors may enhance healing and reduce post-procedure complications. There are no studies examining the effect of A-PRF on the healing of patients with MRONJ. The aim of this study was to retrospectively evaluate treatment outcomes of patients with MRONJ surgically treated without and with the use of A-PRF.
This retrospective study included 28 patients who suffered from osteomyelitis due to MRONJ and underwent surgical treatment between 2019 and 2024. The patients were divided into two groups: the first group received surgical treatment without A-PRF, and the second group received surgical treatment with the application of A-PRF. This study analyzed demographic and clinical data, as well as treatment outcomes.
The patients were aged from 43 to 82 years. The most common cause of MRONJ was the administration of zoledronic acid for oncological reasons (22 patients, 78.6%), given intravenously. In 20 patients (71.4%), the antiresorptive treatment lasted longer than three years. The obtained healing distribution was binomial (presence or absence of healing). Estimation of the probability of healing using the maximum likelihood method provided a result of approximately 64%. The probability of ten or more healed patients in the A-PRF group was 41%. A-PRF helps with a probability of 59%, and without A-PRF, it was lower. Concomitantly, the differences between the group with A-PRF and without A-PRF were not statistically significant.
The patients with MRONJ should have regular check-ups with radiological examinations at least every six months to detect possible recurrence. Treatment for MRONJ is long and difficult. Treatment of non-advanced lesions, without additional risk factors (such as treatment with zoledronate intravenously for oncological purposes for 3 years), showed a better prognosis. Sometimes, in addition to surgery, it is necessary to consider alternative methods. A-PRF may enhance MRONJ healing. However, there is no evidence of a significant effect of A-PRF on the healing of MRONJ.
药物相关性颌骨坏死（MRONJ）是一种药物诱导的骨破坏，在未接受头颈部放疗且未被诊断为面部骨转移的患者中，骨破坏暴露至少6至8周。MRONJ的治疗结果不可预测。因此，人们正在探索替代治疗方法，例如富含生长因子的血液源性富血小板制剂，包括高级富血小板纤维蛋白（A-PRF）。生长因子的存在可能会促进愈合并减少术后并发症。目前尚无研究考察A-PRF对MRONJ患者愈合的影响。本研究的目的是回顾性评估手术治疗的MRONJ患者在未使用和使用A-PRF情况下的治疗结果。
这项回顾性研究纳入了28例因MRONJ导致骨髓炎并在2019年至2024年间接受手术治疗的患者。患者分为两组：第一组接受未使用A-PRF的手术治疗，第二组接受应用A-PRF的手术治疗。本研究分析了人口统计学和临床数据以及治疗结果。
患者年龄在43至82岁之间。MRONJ最常见的病因是出于肿瘤学原因静脉注射唑来膦酸（22例患者，78.6%）。20例患者（71.4%）的抗吸收治疗持续时间超过三年。获得的愈合分布为二项分布（愈合或未愈合）。使用最大似然法估计愈合概率得出的结果约为64%。A-PRF组中十名或更多患者愈合的概率为41%。A-PRF有帮助的概率为59%，未使用A-PRF时概率较低。同时，使用A-PRF组和未使用A-PRF组之间的差异无统计学意义。
MRONJ患者应至少每六个月定期进行放射学检查以检测可能的复发。MRONJ的治疗漫长且困难。对于无其他危险因素（如因肿瘤学目的静脉注射唑来膦酸治疗三年）的非进展性病变，治疗预后较好。有时，除手术外，有必要考虑替代方法。A-PRF可能会促进MRONJ的愈合。然而，没有证据表明A-PRF对MRONJ的愈合有显著影响。
