Laser and platelet-rich plasma to treat medication-related osteonecrosis of the Jaws (MRONJ): A case report

Abstract

Aim: The appropriate management of Medication-Related OsteoNecrosis of the Jaw (MRONJ) is still a challenge for dentists and oral surgeons and in these last years high-technology instruments have been proposed at the different steps of interventions, also combined with promoters of tissue repair. The aim of this report is to show the advantages of a combined approach (laser and PRP) for the treatment of MRONJ. Methods: It is described the case of a patient positive for MRONJ observed at the Odontostomatology and Maxillo-Facial Surgery Unit of the Hospital of Piacenza where surgical approach was performed by using different devices: Er:YAG laser (2940 nm) to remove and vaporize necrotic hard tissue until bleeding bone; Platelet-Rich Plasma (PRP) to stimulate hard and soft tissue healing; diode laser (808 nm) to biostimulate the surgical site. Results: At the time of suture removal, wound closure was observed and the complete healing of the MRONJ site was observed for the 2 years follow up. Conclusion: This case may suggest that this kind of combined approach during all the steps of MRONJ treatment allows to perform a faster and less invasive surgery with a more comfortable postoperative healing process and it represents an innovative approach in this severe adverse event.