Alternative treatments for oral bisphosphonate-related osteonecrosis of the jaws: a pilot study comparing fibrin rich in growth factors and teriparatide
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Pelaz, A.; Junquera Gutiérrez, Luis Manuel; Gallego, Lorena; García-Consuegra, L.; Junquera, Sonsoles; Gómez Alonso, Carlos
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Aquest document és un/a article, creat/da en: 2014
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Objectives: The aim of this study is to describe and compare the evolution of recurrent bisphosphonate-related
osteonecrosis of the jaws (BRONJ) in patients treated with plasma rich in growth factors or teriparatide.
Material and Methods: Two different types of treatments were applied in patients diagnosed of recurrent BRONJ
in a referral hospital for 1.100.000 inhabitants. In the group A, plasma rich in growth factors was applied dur
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ing the surgery. In the group B, the treatment consisted in the subcutaneous administration of teriparatide. All
the cases of BRONJ should meet the following conditions: recurrent BRONJ, impossibility of surgery in stage 3
Ruggiero classification and absence of diagnosed neoplastic disease. Clinical and radiographic evolution of the
patients from both groups was observed.
Results: Nine patients were included, 5 in group A and 4 in group B. All the patients were women on oral bis-
phosphonate therapy for primary osteoporosis (5 patients) or osteoporosis-related to the use of corticosteroids
(4 patients). Alendronate was the most common oral bisphosphonate associated with BRONJ in our study (four
patients in group A and two in group B). The mean age was 72,8 years in the group A and 73,5 years in the group
B. All the patients from group A showed a complete resolution of their BRONJ. Only one patient in the group B
showed the same evolution.
Conclusions: In our series, the plasma rich in growth factors showed better results than the teriparatide in the
treatment of recurrent BRONJ.
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