Autologous platelet concentrates in treatment of medication related osteonecrosis of the jaw.

Background: Medication related osteonecrosis of the jaw (MRONJ) is a severe adverse drug reaction occurring as a progressive bone destruction in the maxillofacial region. MRONJ is usually initiated after oral surgery procedures, however periodontal disease and other chronic inflammations are also risk factors. There is no clear treatment protocol for management of MRONJ, for this reason autologous platelet concentrates (APC) have been introduced to enhance the healing process.

Aim: To evaluate the effectiveness of APCs in treatment of MRONJ.

Methods: A systematic literature review was performed according to PRISMA guidelines in MEDLINE (PubMed) and Google Scholar databases. Only no older than 5 years, in vivo studies in English with follow-up until condition totally resolves were included.

Results: A total of 2683 publications were identified out of which only 7 met the inclusion criteria, 6 cohort and 1 randomized clinical trial. Most of the studies preferred platelet rich fibrin (PRF) and only one used platelet rich plasma (PRP) in MRONJ treatment. MRONJ stage, patients mean age, drug therapy, follow-up and success rate were analysed in all the studies. Five studies also named how MRONJ initiated and 4 studies mentioned duration of drug intake before developing MRONJ.

Conclusion: The published data is not sufficient to confirm a specific treatment protocol although the published results are promising. More prospective randomized controlled clinical trials are required in order to evaluate the effectiveness of APCs for treatment of MRONJ.