Efficacy of leukocyte- and platelet-rich fibrin in the treatment and prevention of medication-related osteonecrosis of the jaw: a prospective study.

Introduction: Medication-related osteonecrosis of the jaws (MRONJ) is a serious condition associated with bone modifying agents (BMAs) intake, leading to impaired bone healing and increased morbidity. Despite various therapeutic approaches, an optimal treatment strategy remains elusive. Leukocyte- and Platelet- Rich fibrin (L-PRF) has emerged as a promising autologous biomaterial due to its regenerative properties. This study aimed to evaluate the efficacy of L-PRF in the treatment and prevention of MRONJ.

Material and methods: A prospective cohort study was conducted, including a total of 30 patients diagnosed with MRONJ (stage I or II) or at risk of developing it (non-MRONJ). Patient underwent standardized treatment involving surgical debridement followed by L-PRF application. Clinical and demographic data were collected, and healing outcomes were assessed at multiple follow-up intervals (7 days, 14 days, 1 month, 3 months and 6 months). Statistical analyses, including Kaplan-Meier survival estimates, were performed to evaluate treatment effectiveness.

Results: The study demonstrated an overall healing of 90%, with a complete recovery in 82.4% of confirmed MRONJ cases and 100% of at-risk patients. L-PRF exhibited good clinical outcomes, including reduced inflammation and pain, accelerated epithelialization, and improved tissue regeneration. The median healing time was estimated at 33.41 days for MRONJ patients and 11.00 for non-MRONJ. No significant differences in healing rates were observed based on age, sex, or systemic conditions.

Conclusions: L-PRF represents a promising adjunct in MRONJ management, improving healing outcomes and postoperative recovery. Its autologous nature and growth factor release enhance bone regeneration, suggesting its potential as both a therapeutic and preventive strategy. Further larger-scale clinical trials are needed to standardize protocols and validate long-term efficacy.