Does the addition of bone morphogenetic protein-2 to platelet-rich fibrin improve healing after treatment for medication-related osteonecrosis of the jaw?

Publication date: Available online 11 December 2016
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Jung-Hyun Park, Jin-Woo Kim, Sun-Jong Kim
ObjectivesIn order to investigate the additional effect of bone morphogenetic protein-2 (BMP-2) to leukocyte-rich and platelet-rich fibrin (L-PRF) on the treatment of medication-related osteonecrosis of jaw (MRONJ), this study compared the healing outcome of combined use of BMP-2 and L-PRF with single use of L-PRF.Patients and MethodsAmong 55 patients who were diagnosed with MRONJ, 25 patients were treated with L-PRF alone, and 30 patients were treated with L-PRF and rhBMP-2. For each patient, surgical sites were evaluated postoperatively at 4 and 16 weeks. Association between treatment method and the resolution of MRONJ were analyzed with the adjustment of patient-specific factors that may influence the treatment outcome.ResultsAt 4 and 16 weeks postoperatively, MRONJ treated with both L-PRF and BMP-2 showed favorable outcomes with complete resolutions of the lesions, which were statistically significant compared to that of the therapy using L-PRF alone (P=0.028). Therefore, the additional use of BMP-2 considerably improved MRONJ healing. Among patient-specific factors, existence of bacterial colony in the biopsy specimen was a significant factor that negatively affects disease resolution (P=0.017).ConclusionThe combined use of BMP-2 and L-PRF leads to the early resolution of MRONJ; thus, patients who need to continue antiresorptive therapy may benefit from combined regimen.



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