Marco Mozzati1, Valentina Arata, Giorgia Gallesio. 1. Department of Clinical Physiopathology, Oral Surgery Unit, Dentistry Section, University of Turin, Turin 10126, Italy. marco.mozzati@libero.it
Abstract
OBJECTIVES: Surgical management of patients following zoledronic acid therapy is particularly difficult, since the dental extraction is the main cause of BRONJ. METHODS: A case-control study was conducted on 176 patients treated withintravenous (IV) bisphosphonatesfor oncologic pathologies who also underwent dental extractions. The study was divided randomly into two groups: 91 were treated with Plasma Rich in Growth Factor Plasma (PRGF) (study group) and the other 85 were not treated with the growth factor preparation (control group). RESULTS:Panoramic X-ray and computed tomography were performed both before and 60 months after surgery. By clinical and radiological diagnosis, BRONJ was diagnosed in only 5 patients in the control group at an average of 91, 6 days after tooth extraction. CONCLUSIONS: We hypothesize that Plasma Rich in Growth Factor (PRGF) is important for the successful treatment of patients on bisphosphonates to restore the osteoblast/osteoclast homeostatic cycles via autologous cytokines. Moreover, this protocol reduces the risk of BRONJ when it is necessary to perform dental extractions in patients undergoing IV bisphosphonate treatment.
RCT Entities:
OBJECTIVES: Surgical management of patients following zoledronic acid therapy is particularly difficult, since the dental extraction is the main cause of BRONJ. METHODS: A case-control study was conducted on 176 patients treated with intravenous (IV) bisphosphonates for oncologic pathologies who also underwent dental extractions. The study was divided randomly into two groups: 91 were treated with Plasma Rich in Growth Factor Plasma (PRGF) (study group) and the other 85 were not treated with the growth factor preparation (control group). RESULTS: Panoramic X-ray and computed tomography were performed both before and 60 months after surgery. By clinical and radiological diagnosis, BRONJ was diagnosed in only 5 patients in the control group at an average of 91, 6 days after tooth extraction. CONCLUSIONS: We hypothesize that Plasma Rich in Growth Factor (PRGF) is important for the successful treatment of patients on bisphosphonates to restore the osteoblast/osteoclast homeostatic cycles via autologous cytokines. Moreover, this protocol reduces the risk of BRONJ when it is necessary to perform dental extractions in patients undergoing IV bisphosphonate treatment.
Authors: T Hasegawa; S Hayashida; E Kondo; Y Takeda; H Miyamoto; Y Kawaoka; N Ueda; E Iwata; H Nakahara; M Kobayashi; S Soutome; S I Yamada; I Tojyo; Y Kojima; M Umeda; S Fujita; H Kurita; Y Shibuya; T Kirita; T Komori Journal: Osteoporos Int Date: 2018-11-07 Impact factor: 4.507