Non-Interventional Prospective Observational Study of Platelet Rich Fibrin as a Therapy Adjunctive in Patients with Medication-Related Osteonecrosis of the Jaw.
MRONJ
angiogenesis
platelet rich fibrin
Journal
Journal of clinical medicine
ISSN: 2077-0383
Titre abrégé: J Clin Med
Pays: Switzerland
ID NLM: 101606588
Informations de publication
Date de publication:
28 Jan 2022
28 Jan 2022
Historique:
received:
06
01
2022
revised:
19
01
2022
accepted:
26
01
2022
entrez:
15
2
2022
pubmed:
16
2
2022
medline:
16
2
2022
Statut:
epublish
Résumé
Medication-related osteonecrosis (MRONJ) of the jaw is a severe and feared side effect of antiresorptive therapy in the oncological setting. With growing evidence that impaired angiogenesis may represent a key factor in pathogenesis, the aim of this study was to evaluate an autologous platelet concentrate as a possible additive in surgical therapy to optimize vascularization and, subsequently, resolution rates. A non-interventional, prospective, multicenter study was conducted, and all patients with stage I-III MRONJ, undergoing antiresorptive therapy for an oncological indication, were included. The necrosis was treated surgically without (study arm A) or with (arm B) the addition of an autologous platelet concentrate (platelet-rich fibrin, PRF). After 5, 14, and 42 days postoperative, wound healing (primary outcome: mucosal integrity) as well as downstaging, pain perception, and oral health-related quality of life (secondary outcome) were assessed via clinical evaluation. Among the 52 patients included, primarily with MRONJ stage I and II, the use of PRF as an additive in surgical therapy did not display a significant advantage for wound healing ( In conclusion, PRF as an adjunct did not significantly optimize wound healing. Further, no significant changes in terms of downstaging, pain sensation, and oral health-related quality of life were found.
Sections du résumé
BACKGROUND
BACKGROUND
Medication-related osteonecrosis (MRONJ) of the jaw is a severe and feared side effect of antiresorptive therapy in the oncological setting. With growing evidence that impaired angiogenesis may represent a key factor in pathogenesis, the aim of this study was to evaluate an autologous platelet concentrate as a possible additive in surgical therapy to optimize vascularization and, subsequently, resolution rates.
MATERIAL AND METHODS
METHODS
A non-interventional, prospective, multicenter study was conducted, and all patients with stage I-III MRONJ, undergoing antiresorptive therapy for an oncological indication, were included. The necrosis was treated surgically without (study arm A) or with (arm B) the addition of an autologous platelet concentrate (platelet-rich fibrin, PRF).
RESULTS
RESULTS
After 5, 14, and 42 days postoperative, wound healing (primary outcome: mucosal integrity) as well as downstaging, pain perception, and oral health-related quality of life (secondary outcome) were assessed via clinical evaluation. Among the 52 patients included, primarily with MRONJ stage I and II, the use of PRF as an additive in surgical therapy did not display a significant advantage for wound healing (
SUMMARY
CONCLUSIONS
In conclusion, PRF as an adjunct did not significantly optimize wound healing. Further, no significant changes in terms of downstaging, pain sensation, and oral health-related quality of life were found.
Identifiants
pubmed: 35160132
pii: jcm11030682
doi: 10.3390/jcm11030682
pmc: PMC8837070
pii:
doi:
Types de publication
Journal Article
Langues
eng
Subventions
Organisme : Deutsche Forschungsgemeinschaft
ID : BL 1701/1-1; NA 1592/1-1
Références
Pharmaceuticals (Basel). 2020 Nov 25;13(12):
pubmed: 33255626
Bone. 2020 Dec;141:115676
pubmed: 33022455
J Craniomaxillofac Surg. 2020 Mar;48(3):268-285
pubmed: 32063481
Cochrane Database Syst Rev. 2017 Oct 06;10:CD012432
pubmed: 28983908
Clin Oral Investig. 2017 Jul;21(6):1913-1927
pubmed: 28551729
PLoS One. 2017 Jun 8;12(6):e0179248
pubmed: 28594896
Cell Transplant. 2020 Jan-Dec;29:963689720948497
pubmed: 33086890
J Craniomaxillofac Surg. 2016 Oct;44(10):1694-1699
pubmed: 27591091
Br J Oral Maxillofac Surg. 2014 Nov;52(9):854-9
pubmed: 25138613
J Oral Maxillofac Surg. 2018 Jul;76(7):1460-1463
pubmed: 29425752
J Oral Maxillofac Surg. 2009 May;67(5 Suppl):85-95
pubmed: 19371819
Front Immunol. 2021 Feb 25;12:606043
pubmed: 33717086
J Oral Maxillofac Surg. 2014 Oct;72(10):1938-56
pubmed: 25234529
Biomedicines. 2021 Jan 10;9(1):
pubmed: 33435244
Clin Implant Dent Relat Res. 2018 Dec;20(6):1030-1035
pubmed: 30324746
Clin Ter. 2017 Jul-Aug;168(4):e253-e257
pubmed: 28703840
Adv Skin Wound Care. 2013 Aug;26(8):360-73
pubmed: 23860221
Support Care Cancer. 2021 Nov;29(11):6713-6719
pubmed: 33973080
J Stomatol Oral Maxillofac Surg. 2018 Nov;119(5):389-394
pubmed: 29680775
J Clin Exp Dent. 2014 Feb 01;6(1):e22-8
pubmed: 24596631
J Clin Exp Dent. 2017 Aug 1;9(8):e1051-e1059
pubmed: 28936298
Clin Oral Investig. 2021 May;25(5):2845-2857
pubmed: 32964311
J Korean Assoc Oral Maxillofac Surg. 2018 Oct;44(5):225-231
pubmed: 30402414
Oncol Rev. 2014 Sep 23;8(2):254
pubmed: 25992241
Clin Oral Investig. 2017 Sep;21(7):2165-2172
pubmed: 27837344
J Oral Maxillofac Surg. 2003 Sep;61(9):1115-7
pubmed: 12966493
J Bone Metab. 2021 Nov;28(4):279-296
pubmed: 34905675
Front Bioeng Biotechnol. 2021 Mar 16;9:640053
pubmed: 33816452
Indian J Dent Res. 2020 Sep-Oct;31(5):813-818
pubmed: 33433526
Clin Oral Investig. 2020 Dec;24(12):4625-4637
pubmed: 32444918
Int J Environ Res Public Health. 2021 Aug 10;18(16):
pubmed: 34444181
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011 Aug;112(2):216-21
pubmed: 21664154
J Clin Med. 2021 Sep 29;10(19):
pubmed: 34640498
Oral Dis. 2020 Nov;26(8):1783-1792
pubmed: 32510714
J Biomater Appl. 2020 Jul;35(1):83-96
pubmed: 32237950
Int J Environ Res Public Health. 2021 Aug 04;18(16):
pubmed: 34443998
Clin Oral Investig. 2019 May;23(5):2179-2185
pubmed: 30280327
J Bone Miner Res. 2015 Jan;30(1):3-23
pubmed: 25414052
Oral Dis. 2019 Oct;25(7):1815-1821
pubmed: 31325201
J Craniomaxillofac Surg. 2019 Mar;47(3):491-499
pubmed: 30642734
J Biol Regul Homeost Agents. ;31(3):811-816
pubmed: 28958140
Oral Surg Oral Med Oral Pathol Oral Radiol. 2019 Apr;127(4):289-299
pubmed: 30713092
Clin Oral Investig. 2020 May;24(5):1663-1675
pubmed: 31346783
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006 Mar;101(3):e37-44
pubmed: 16504849
J Clin Med. 2020 Oct 29;9(11):
pubmed: 33138266
Eur J Cancer. 2015 Jan;51(1):62-74
pubmed: 25466505
J Periodontal Res. 2018 Oct;53(5):793-800
pubmed: 29858875
Gerodontology. 2019 Dec;36(4):313-324
pubmed: 31373407
J Oral Maxillofac Surg. 2020 Nov;78(11):1986-1999
pubmed: 32615096
Eur Urol. 2008 Nov;54(5):1066-72
pubmed: 18602738
Oral Oncol. 2020 Jul;106:104659
pubmed: 32209313
J Bone Miner Res. 2020 Nov;35(11):2179-2192
pubmed: 32568416
Curr Osteoporos Rep. 2018 Oct;16(5):584-595
pubmed: 30155844
J Oral Maxillofac Surg. 2014 Feb;72(2):322-6
pubmed: 24075235
Clin Oral Investig. 2020 Oct;24(10):3425-3436
pubmed: 32030513
Cancer Treat Rev. 2018 Sep;69:177-187
pubmed: 30055439
Med Oral Patol Oral Cir Bucal. 2021 Nov 1;26(6):e684-690
pubmed: 34704981
Nat Rev Rheumatol. 2011 Nov 29;8(2):90-6
pubmed: 22124271
Expert Opin Biol Ther. 2017 Feb;17(2):197-212
pubmed: 27845852
J Oral Maxillofac Surg. 2017 Jun;75(6):1176-1184
pubmed: 28042979
Am J Sports Med. 2018 Feb;46(2):409-419
pubmed: 29211968
J Craniomaxillofac Surg. 2018 May;46(5):815-824
pubmed: 29631942
Medicina (Kaunas). 2021 May 09;57(5):
pubmed: 34065104
J Am Dent Assoc. 2017 Aug;148(8):584-594.e2
pubmed: 28527518
J Stomatol Oral Maxillofac Surg. 2020 Feb;121(1):84-89
pubmed: 30794883
J Clin Oncol. 2005 Dec 1;23(34):8580-7
pubmed: 16314620
Front Bioeng Biotechnol. 2021 Feb 17;9:599224
pubmed: 33681155