Treatment of bisphosphonate-related osteonecrosis of the jaw with platelet-rich fibrin

Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is a well-known potential complication of bisphosphonate treatment.The clinical findings of BRONJ may vary in patients, including exposed necrotic bone, which can be accompanied by pain, swelling, paresthesia, pus discharge, and soft tissue ulceration.Currently, the management of BRONJ remains controversial, and there is no definitive treatment other than the standard protocol.Choukroun's platelet-rich fibrin (PRF) represents a relatively new biotechnology for the stimulation and acceleration of tissue healing and bone regeneration.1 In this study, we report a BRONJ patient who was treated with surgical debridement, sequestrectomy, and simultaneous reconstruction using PRF as the sole grafting material.A 79-year-old woman was referred in July 2011 by a local dental clinic for a painful jaw bone lesion.Her medical history included osteoporosis since 1996, which was treated weekly with alendronate (Fosamax, 70 mg, per os; Merck, Whitehouse Station, NJ, USA) for 10 more years, and intravenous zoledronic acid (Aclasta; Norvatis Pharmaceuticals, Frimley, Camberley, UK) infusions annually, at a dose of 5 mg, from 2010 to 2011.The intraoral examination revealed a diffuse, tender, erythematous swelling over the edentulous area at the right posterior mandible with a purulent discharge Conflicts of interest: The authors have no conflicts of interest relevant to this article.