Odontom Cerrahisinde Bisfosfonat Osteonekrozunu Önlemek için L-PRF Kullanımı: Vaka Raporu

Öz

İlaca bağlı çene osteonekrozu (MRONJ), antirezorptif ve/veya antianjiyojenik ilaçların kullanımına bağlı avasküler çene kemiği nekrozudur. Günümüzde antirezorptif ve antianjiyojenik ilaçlar osteoporoz, multipl miyelom, Paget hastalığı gibi hastalıklarda ve kanser metastazlarının önlenmesinde sıklıkla kullanılmaktadır. Giderek yaygınlaşan ve tedavisi zor olabilen MRONJ için birçok alternatif tedavi yöntemi önerilmiştir. Trombositten zengin kan konsantreleri bu tedavi yöntemlerinden biridir. Sunduğumuz olguda MRONJ'u önlemek için L-PRF konsantresi kullandık ve başarılı sonuçlar elde ettik.

Anahtar Kelimeler

• L-PRF
• MRONJ
• odontoma
• gömülü diş

THE USE OF L-PRF TO PREVENT BISPHOSPHONATE OSTEONECROSIS IN ODONTOMA SURGERY: CASE REPORT

Öz

Medication related osteonecrosis of the jaw (MRONJ) is avascular jawbone necrosis due to the use of antiresorptive and/or antiangiogenic drugs. Today; antiresorptive and antiangiogenic drugs are frequently used in diseases such as osteoporosis, multiple myeloma, Paget's disease, and prevention of cancer metastases. Many alternative treatment methods have been proposed for MRONJ, which is increasingly common and can be difficult to resolve. Platelet-rich blood concentrates are one of these treatment methods. In the case we presented, we used L-PRF concentrate to prevent MRONJ and we achieved successful results.

Anahtar Kelimeler

• L-PRF
• MRONJ
• odontoma
• impacted tooth

Kaynakça

1. Nicolatou-Galitis O, Schiødt M, Mendes RA, Ripamonti C, Hope S, Drudge-Coates L, Niepel D, Van den Wyngaert T. Medication-related osteonecrosis of the jaw: definition and best practice for prevention, diagnosis, and treatment. Oral Surg Oral Med Oral Pathol Oral Radiol. 2019 Feb;127(2):117-135. doi: 10.1016/j.oooo.2018.09.008. Epub 2018 Oct 9. PMID: 30393090.
2. Pichardo SE, Richard van Merkesteyn JP. Bisphosphonate-related osteonecrosis of the jaws: spontaneous or dental origin? Oral Surg Oral Med Oral Pathol Oral Radiol. 2013;116:287–92.
3. Drake MT, Clarke BL, Khosla S. Bisphosphonates: mechanism of action and role in clinical practice. Mayo Clin Proc. 2008; 83: 1032-1045
4. Food and Drug Administration. “XGEVA (denosumab) Prescribing information.” (2015).
5. Miranda M, Gianfreda F, Raffone C, Antonacci D, Pistilli V, Bollero P. The Role of Platelet-Rich Fibrin (PRF) in the Prevention of Medication-Related Osteonecrosis of the Jaw (MRONJ). Biomed Res Int. 2021 May 13;2021:4948139. doi: 10.1155/2021/4948139. PMID: 34095295; PMCID: PMC8140838.
6. Cano-Durán JA, Peña-Cardelles JF, Ortega-Concepción D, Paredes-Rodríguez VM, García-Riart M, López- Quiles J. The role of Leucocyte-rich and platelet-rich fibrin (L-PRF) in the treatment of the medication-related osteonecrosis of the jaws (MRONJ). J Clin Exp Dent. 2017 Aug 1;9(8):e1051-e1059. doi: 10.4317/jced.54154. PMID: 28936298; PMCID: PMC5601107.
7. Kim JW, Kim SJ, Kim MR. Leucocyte-rich and plateletrich fibrin for the treatment of bisphosphonate-related osteonecrosis of the jaw: a prospective feasibility study. Br J Oral Maxillofac Surg. 2014;52:854–59.
8. Jamalpour MR, Shahabi S, Baghestani M, Shokri A, Jamshidi S, Khazaei S. Complementarity of surgical therapy, photobiomodulation, A-PRF and L-PRF for management of medication-related osteonecrosis of the jaw (MRONJ): an animal study. BMC Oral Health. 2022 Jun 18;22(1):241. doi: 10.1186/s12903-022-02275-2. PMID: 35717177; PMCID: PMC9206277.

9. Samieirad S, Labafchi A, Famili K, Hashemzadeh H. Medication-Related Osteonecrosis of the Jaw (MRONJ) due to Simvastatin: An Unusual Case Report. World J Plast Surg. 2021 Jan;10(1):132-135. doi: 10.29252/ wjps.10.1.132. PMID: 33833966; PMCID: PMC8016372.
10. Nørholt S, Hartlev J. Surgical treatment of osteonecrosis of the jaw with the use of platelet-rich fibrin: a prospective study of 15 patients. Int J Oral Maxillofac Surg. 2016;45(10):1256–1260. doi: 10.1016/j. ijom.2016.04.010.
11. Choukroun J, Diss A, Simonpieri A, Girard M-O, Schoeffler C, Dohan SL, Dohan AJ, Mouhyi J, Dohan DM. Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part IV: clinical effects on tissue healing. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006;101(3):e56–e60. doi: 10.1016/j.tripleo.2005.07.011.
12. Dohan Ehrenfest DM, de Peppo GM, Doglioli P, Sammartino G. Slow release of growth factors and thrombospondin-1 in Choukroun’s platelet-rich fibrin (PRF): a gold standard to achieve for all surgical platelet concentrates technologies. Growth Factors. 2009;27(1):63–69. doi: 10.1080/08977190802636713.