Abstract:
Medication-related osteonecrosis of the jaws (MRONJ) is a serious debilitating disease resulting from long-term treatment with Antiresorptive drugs such as Bisphosphonates or Denosumab, which significantly affects patients\' quality of life. A 43-year-old female patient with stage 4 breast cancer and treated with Zoledronic Acid for bone metastases was referred to the Department of Oral Medicine at the Faculty of Dentistry, Damascus University. The main complaint was pain in the right maxilla. Intraoral examination showed an exposure of necrotic bone in the right maxillary region with presence of purulent exudate. The treatment plan was discussed with the patient. Treatment included resection of all necrotic bone and application of Advanced platelet-rich fibrin (A-PRF) clots and membranes. Follow-up and outcome were conducted by clinical measures to assess healing and recurrence (6-month follow-up). Topical treatment with A-PRF demonstrated a reduction in pain and resulted in complete wound healing within 30 days. A-PRF stimulates the release of growth factors and chemotaxis involved in tissue repair mechanisms. This method seemed to be effective in the treatment of MRONJ.
摘要:
药物相关的颌骨坏死(MRONJ)是一种严重的衰弱性疾病,由长期使用抗二膦酸盐或Denosumab等抗吸收药物治疗引起,这显著影响患者的生活质量。一名43岁的女性患者患有4期乳腺癌,并接受唑来膦酸治疗骨转移,被转诊至牙科学院口腔医学系,大马士革大学。主要主诉是右上颌骨疼痛。口内检查显示右上颌区域坏死骨暴露,存在脓性渗出物。与患者讨论了治疗方案。治疗包括切除所有坏死骨和应用晚期富血小板纤维蛋白(A-PRF)凝块和膜。通过临床措施进行随访和结果,以评估愈合和复发(6个月随访)。用A-PRF的局部治疗显示疼痛减轻,并在30天内导致完全的伤口愈合。A-PRF刺激参与组织修复机制的生长因子释放和趋化性。这种方法似乎对MRONJ的治疗有效。