Leukocyte and platelet rich fibrin in the management of medication-related osteonecrosis of the jaw: a systematic review and meta-analysis

• Ana Muñoz-Salgado ^[1] ; Fábio França Vieira e Silva ^[4] ; María Elena Padín-Iruegas ^[2] ; Gisela Cristina Vianna Camolesi ^[4] ; Wilber Edison Bernaola-Paredes ^[5] ; Henrique Rocha Mazorchi Veronese ^[6] ; Miriã de Andrade Celestino ^[6] ; William Jose Silva Filho ^[3] ; Alejandro I Lorenzo-Pouso ^[1] ; Mario Pérez-Sayáns ^[4]
  1. [1] Universidade de Santiago de Compostela

     Universidade de Santiago de Compostela

     Santiago de Compostela, España

     
  2. [2] Universidade de Vigo

     Universidade de Vigo

     Vigo, España

     
  3. [3] Universidade Federal de Sergipe

     Universidade Federal de Sergipe

     Brasil

     
  4. [4] Oral Medicine, Oral Surgery and Implantology Unit (MedOralRes), Faculty of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain; ORALRES Group, Health Research Institute of Santiago de Compostela (FIDIS), Santiago de Compostela, Spain
  5. [5] Department of Radiation Oncology, A.C. Camargo Cancer Center, Sao Paulo, Brazil
  6. [6] Department of Stomatology, School of Dentistry, UNIFAMINAS, Minas Gerais, Brazil

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• Localización: Medicina oral, patología oral y cirugía bucal. Ed. inglesa, ISSN-e 1698-6946, Vol. 28, Nº. 4 (July), 2023
• Idioma: inglés
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• Resumen

  • Osteonecrosis of the jaw (ONJ) has a frequent adverse effect after the administration of nitrogenous bisphosphonates, as non-nitrogenous bisphosphonates are metabolized more rapidly and would produce this effect to a lesser extent. The objective of this study is to analyze the results obtained in the literature with the use of L-PRF in the treatment of ONJ through a systematic review and meta-analysis.

    Material and methods: Medline (via PubMed), Cochrane, Web of Science and Grey Literature Database was screened from which 10 were selected.

    In the meta-analysis with full resolution, combining the use of L-PRF in the treatment of ONJ, a weighted proportion (PP) of 94.3% of complete resolution is obtained (95% CI: 91.2-97.4, p<0.001), with a low degree of heterogeneity, statistically significant (I2 = 29.02%; p<0.001). When analyzing the non-resolution data, a weighted proportion (PP) of 7.7% (95% CI: 3.6-11.9; p<0.001) was obtained with moderate heterogeneity (I2: 41.87%; p=0.112). In the meta-regression, no significant correlation was found between complete resolution and year of publication (intercept = 2.88, p=0.829). In consistency analysis no major changes in PP are identified when any of the studies are eliminated, demonstrating a high reliability in the combined results.

    Conclusion: L-PRF alone or in combination with other therapies in treatment of ONJ achieved high percentages of complete lesion resolution (94.3%). In studies where L-PRF is combined with other therapies, and where the effectiveness of the other therapy alone is analyzed, L-PRF has been shown higher percentages of resolution.