The use of advanced‐platelet rich fibrin (A‐PRF) in the management of medication‐related osteonecrosis of the jaw (MRONJ): A case report

Medication‐related osteonecrosis of the jaws (MRONJ) is a serious debilitating disease resulting from long‐term treatment with Antiresorptive drugs such as Bisphosphonates or Denosumab, which significantly affects patients' quality of life. A 43‐year‐old female patient with stage 4 breast cancer and treated with Zoledronic Acid for bone metastases was referred to the Department of Oral Medicine at the Faculty of Dentistry, Damascus University. The main complaint was pain in the right maxilla. Intraoral examination showed an exposure of necrotic bone in the right maxillary region with presence of purulent exudate. The treatment plan was discussed with the patient. Treatment included resection of all necrotic bone and application of Advanced platelet‐rich fibrin (A‐PRF) clots and membranes. Follow‐up and outcome were conducted by clinical measures to assess healing and recurrence (6‐month follow‐up). Topical treatment with A‐PRF demonstrated a reduction in pain and resulted in complete wound healing within 30 days. A‐PRF stimulates the release of growth factors and chemotaxis involved in tissue repair mechanisms. This method seemed to be effective in the treatment of MRONJ.