Management of Medication-Related Osteonecrosis of the Jaw Using Platelet-Rich Fibrin: A Case Report and Literature Review

The aim of the present study was to report the successful treatment of medication-related osteonecrosis of the jaw (MRONJ) using platelet-rich fibrin (PRF) as a wound-healing accelerator in patients who underwent bisphosphonate therapy with a history of tooth extraction.

A 65-year-old woman referred to the Oral and Maxillofacial Surgery Department of Mashhad Dental School in Mashhad, Iran, complaining of pain, swelling, and infection in the right maxilla area with a history of tooth extraction. Bone exposure, with infection and pain in the extraction area, started about 2 weeks after the extraction of the upper right second premolar and remained in the patient's mouth for more than 8 weeks when MRONJ was diagnosed. The PRF was prepared using 10 ml of the patient blood. The necrotic bone was removed with caution. The PRF was then inserted to the surgery site, and the flap was sutured without stretching. No complications were observed in the 6-month-old follow-up, and all the symptoms were discontinued.

According to the results of our study and other reviewed studies, the use of PRF after surgery can have a beneficial effect on bone and wound healing in the MRONJ case. The PRF has a simpler and cheaper technique than alternative treatments and can be used as a novel approach in MRONJ treatment.