Del Vecchio, Alessandro

Gaglioti, Domenico

Montori, Alessandra

Palaia, Gaspare

Rocchetti, Federica

Romeo, Umberto

Tenore, Gianluca

MONTORI ALESSANDRA

ROCCHETTI FEDERICA

DEL VECCHIO ALESSANDRO

PALAIA GASPARE

TENORE GIANLUCA

GAGLIOTI DOMENICO

ROMEO UMBERTO

Archivio della ricerca- Università di Roma La Sapienza

aBStract 18 MiNerVa StoMatologica June 2018other 2 cases were caused by implant rehabilitation respectively of tooth 4.6 in a patient treated with Xgeva® and of tooth 2.4 in a patient who had assumed Zometa®. all patients followed their treatments along 2 years.all the patients received the same protocol:— Pre-surgical: 1g of amoxicillin + clavulanic acid and 500 mg of Metronidazole route os twice a day starting three days before surgery and with mouth rinses with 0,2% chlorhexidine gluconate. — Surgical: necrotic bone was removed with piezosurgery and rotary burs, a curettage was performed until bleeding. l-PrF membranes were obtained through a single centrifuga-tion of patient’s blood samples for a period of 12 minutes at 400 rpm, using the l-PrF centrifuge intraspin by intralock® international. after centrifugation, each l-PrF clot was sepa-rated from serum and placed on a sterile surgical plate in order to obtain two thin membranes that were accurately positioned on the bone defects and stabilized with a resorbable suture.— Post-surgical: for 7 days after surgery the same antibiotic and antiseptic regimen of preoperative was prescribed and patients received daily applications of lllt with a double diode laser (lumix 2 Prodent, italy), realizing scanning move-ment on the surgical site with 0,5 W in cW for 15’ at 146,7 J.Patients were followed up to 3 months postoperatively.reSUltS: complete healing of the MroNJ sites were observed for 2 patients while the third one had recurrence.coNclUSioNS: Despite our limited experience, l-PrF and lllt may contribute to a successful outcome in MroNJ management. l-PrF acts as a physical barrier against micro-organisms while lllt stimulates tissue regeneration and angio-genesis, accelerating the healing process. Further studies on a larger group of patients with a longer follow-up are needed to confirm the efficacy of the association of l-PrF and lllt.reFereNceS:1.  lopez-Jornet P, Sanchez Perez a, amaral Mendes r, tobias a. Medication-related osteonecrosis of the jaw: is autologous platelet concentrate application effective for prevention and treatment? a systematic review. Journal of cranio-Maxillo-Facial Surgery 44 (2016) 1067-1062. 2.  correa Momesso ga, De Souza Batista Fr, alves de Sousa c, Nunes de lima V, Braga Polo to, Suerni Hassumi J, rangel garcia Junior i and Perez Faverani l. Successful use of low-level laser therapy in the treatment of Medication-related osteonecrosis of the Jaw. J laser Med Sci. 2017 autumn; 8(4): 201-203. 3.  raeissadat Sa1,1, Babaee M1,1, rayegani SM1,1, Hashemi Z1,1, Hamidieh aa2,2, Mojgani P3,3, Fouladi Vanda H4,4. an overview of platelet products (PrP, PrgF, PrF, etc.) in the iranian studies. Future Sci oa. 2017 Jul 28;3(4):FSo231. doi: 10.4155/fsoa-2017-0045. ecollec-tion 2017 Nov. B18 - CGF membrane in the management of medication related osteonecrosis of the jaw: a case reportl. Sardelli *, r. ippolito, r. Parrulli, F. Bolognesi, c. MarchettiUnit of Oral and Maxillofacial Surgery, Department of Biomed-ical and Neuromotor Science (DIBINEM), Alma Mater Studio-rum, University of Bologna, Bologna, ItalyMedication-related osteonecrosis of the jaw (MroNJ) is a severe complication of certain drugs used for the treatment of osteo-met-abolic or cancer disease. to date, the management of this com-plication is controversial and variable on the basis of the necrosis one). one month later, the patient showed enlargement of the known little palatal bone exposure and a huge right mandible exposure (region 4.3-4.5), at the level of toothbrush trauma, associated with 4.5 bicuspid mobility (grade 2); he suffered for lip hypoesthesia and not severe pain (VaS 2-3). Unfortunately, follow-up is lacking due to death of the patient, five months later, after cancer progression.DiScUSSioN: this case apparently confirms that suni-tinib-related and denosumab-related oNJ might have less pronounced ct alterations in comparison with those usu-ally observed in BroNJ cases. However a possible aid to diagnosis from nuclear medicine techniques is deducible in this case, as well as recently described in BroNJ literature, reporting that bone scan might be more sensible (even if not specific) in identifying oNJ areas. reFereNceS:1.  Bedogni a, Fusco V, agrillo a, campisi g. learning from experience. Proposal of a refined definition and staging system for bisphosphonate- related osteonecrosis of the jaw (BroNJ). oral Dis. 2012;18(6):621–3.2.  Fusco V, Muni a, rouhanifar H, greco B, tommasi l. is bone scan (tc99 scintigraphy) uptake predictive of clinical onset of osteonecrosis of jaw (oNJ)? ann Stomatol (roma) 2014 apr-Jun; 5(2 Suppl): 11. Published online 2014 May 9. PMciD: PMc43776713.  thomas c, Spanidis M, engel c, et al. Bone scintigra-phy predicts bisphosphonate-induced osteonecrosis of the jaw (BroNJ) in patients with metastatic castration-resis-tant prostate cancer (mcrPc). clin oral investig. 2016 May;20(4):753-8. doi: 10.1007/s00784-015-1563-8. epub 2015 aug 26.B17 - L-PRF AND LLLT as adjuvant treat-ments in MRONJ: case series a. Montori*, F. rocchetti, a. Del Vecchio, g. Palaia, g. teno-re, D. gaglioti, U. romeoDAI Head-Neck, Policlinic Umberto I, Rome, ItalyBacKgroUND: Nowadays MroNJ’s management remains a challenge. the choice between conservative and invasive treat-ments must be established case-by-case. complementary treat-ments include the use of low level laser therapy (lllt) and platelets concentrates with the aim to improve bone and mucosal healing. among platelet concentrates, leukocyte and platelet-rich fibrin (l-PrF) is the most recently introduced. l-PrF consists in an autologous three-dimensional material with high concentration of leukocytes and growth factors which promotes neo-angiogen-esis, inflammatory homeostasis and stimulates collagen produc-tion. a specific and validated protocol for using platelet deriva-tives in dentistry has still not defined; nevertheless, literature reports countless examples of their application for preventive and therapeutic purposes about the bone and mucosal tissues defects. Specifically, PrF membranes due to the high density of fibrin fibers are very resistant to mechanical stress frequent in the oral cavity and can resist longer to proteolytic degeneration. lllt is a non invasive treatment with antibacterial, analgesic and biostimu-lating effects that increases the mitotic index and the differentia-tion of osteoblasts and relieve pain. the aim of this report is to describe the management of 3 MroNJs patients treated through the l-PrF and lllt to support the surgical approach. MetHoDS: three patients affected by symptomatic MroNJ stage 2 according to SicMF-SiPMo classification were treated at our Department. one lesion appeared on the toothless ridge bone of the third quadrant in a patient treated with Zometa®; the This document is protected by international copyright laws. No additional reproduction is authorized. It is permitted for personal use to download and save only one file and print only one copy of this Article. It is not permitted to make additional copies (either sporadically or systematically, either printed or electronic) of the Article for any purpose. It is not permitted to distribute the electronic copy of the article through online internet and/or intranet file sharing systems, electronic mailing or any other means which may allow access to the Article. The use of all or any part of the Article for any Commercial Use is not permitted. The creation of derivative works from the Article is not permitted. The production of reprints for personal or commercial use is not permitted. It is not permitted to remove, cover,  overlay, obscure, block, or change any copyright notices or terms of use which the Publisher may post on the Article. It is not permitted to frame or use framing techniques to enclose any trademark, logo, or other proprietary information of the Publisher.

English

L-PRF AND LLLT as adjuvant treatments in MRONJ: case series

L-PRF AND LLLT as adjuvant treatments in MRONJ: case series

Abstract

Similar works

Full text

Available Versions

Archivio della ricerca- Università di Roma La Sapienza