open access
메뉴
open access
메뉴
ISSN : 0376-4672
Bisphosphonates are widely used mainly for the treatment of osteoporosis and bone metastasis of malignancy. Since the first report of MRONJ, there have been many studies associated, however the pathogenesis of MRONJ is not yet clear. Medicationrelated osteonecrosis of the jaws (MRONJ) is a serious complication associated with long-term medication therapy. It is characterized by exposed necrotic bonein the jaw, which has persisted for more than 8weeks despite continuous treatment by dentist. The mechanism of development of MRONJ is still unclear and there is no definitive standard treatment for MRONJ. The purpose of this study is to investigate the jaw bone destruction mechanism of accumulated bisphosphonates, so that we can develop therapeutic method to repair the defect and stop the destruction process. The authors performed simultaneous application of PRF(Platelet rich fibrin) and BMP-2(Bone morphogenetic protein-2) to stimulate not only soft tissue healing but also osseous regeneration. Our case series demonstrate that simultaneous application of platelet rich fibrin and bone morphogenetic protein-2 can be a treatment of choice for MRONJ.
1. Marx RE. Pamidronate (Aredia) and zoledronate (Zometa) induced avascular necrosis of the jaws:a growing epidemic. Journal of Oral and Maxillofacial Surgery. 9// 2003;61(9):1115-1117.
2. Ruggiero SL, Dodson TB, Fantasia J, et al. American Association of Oral and Maxillofacial Surgeons Position Paper on Medication-Related Osteonecrosis of the Jaw?2014 Update. Journal of Oral and Maxillofacial Surgery. 10//2014;72(10):1938-1956.
3. Khosla S, Burr D, Cauley J, et al. Bisphosphonateassociated osteonecrosis of the jaw: report of a task force of the American Society for Bone and Mineral Research. Journal of bone and mineral research. 2007;22(10):1479-1491.
4. Ruggiero SL. Emerging concepts in the management and treatment of osteonecrosis of the jaw. Oral and maxillofacial surgery clinics of North America. 2013;25(1):11-20, v.
5. Kim JW, Kim SJ, Kim MR. Leucocyte-rich and platelet-rich fibrin for the treatment of bisphosphonate-related osteonecrosis of the jaw: a prospective feasibility study. The British journal of oral & maxillofacial surgery. Nov 2014;52(9):854-859.
6. Chen D, Zhao M, Mundy GR. Bone morphogenetic proteins. Growth factors. 2004;22(4):233-241.
7. Subramanian G, Cohen HV, Quek SY. A model for the pathogenesis of bisphosphonate-associated osteonecrosis of the jaw and teriparatide's potential role in its resolution. Oral surgery, oral medicine, oral pathology, oral radiology and endodontology. 2011;112(6):744-753.
8. Dohan DM, Choukroun J, Diss A, et al. Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part I: technological concepts and evolution. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology. 2006;101(3):e37-e44.
9. Choukroun J, Diss A, Simonpieri A, et al. Plateletrich fibrin (PRF): a second-generation platelet concentrate. Part IV: clinical effects on tissue healing. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology. 2006;101(3):e56-e60.
10. Ehrenfest DMD, Rasmusson L, Albrektsson T. Classification of platelet concentrates: from pure platelet-rich plasma (P-PRP) to leucocyte-and platelet-rich fibrin (L-PRF). Trends in biotechnology. 2009;27(3):158-167.
11. Kim RY, Oh JH, Lee BS, Seo Y-K, Hwang SJ, Kim IS. The effect of dose on rhBMP-2 signaling, delivered via collagen sponge, on osteoclast activation and in vivo bone resorption. Biomaterials. 2014;35(6):1869-1881.
12. Gerard DA, Carlson ER, Gotcher JE, Pickett DO. Early inhibitory effects of zoledronic acid in tooth extraction sockets in dogs are negated by recombinant human bone morphogenetic protein. Journal of Oral and Maxillofacial Surgery. 2014;72(1):61-66.
13. Cicciú M, Herford AS, Juodzbalys G, Stoffella E. Recombinant human bone morphogenetic protein type 2 application for a possible treatment of bisphosphonates-related osteonecrosis of the jaw. Journal of Craniofacial Surgery. 2012;23(3):784-788.
14. Kawamura M, URIST MR. Human fibrin is a physiologic delivery system for bone morphogenetic protein. Clinical orthopaedics and related research. 1988;235:302-310.