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Tips and Tricks and Clinical Outcome of Cryopreserved Human Amniotic Membrane Application for the Management of Medication-Related Osteonecrosis of the Jaw (MRONJ): A Pilot Study

Medication-related osteonecrosis of the jaw (MRONJ) is a complication of certain pharmacological treatments such as bisphosphonates, denosumab, and angiogenesis inhibitors. There are currently no guidelines on its management, particularly in advanced stages. The human amniotic membrane (hAM) has low...

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Autores principales: Odet, Stéphane, Meyer, Christophe, Gaudet, Camille, Weber, Elise, Quenot, Julie, Derruau, Stéphane, Laurence, Sebastien, Bompy, Lisa, Girodon, Marine, Chatelain, Brice, Mauprivez, Cédric, Brenet, Esteban, Kerdjoudj, Halima, Zwetyenga, Narcisse, Marchetti, Philippe, Hatzfeld, Anne-Sophie, Toubeau, David, Pouthier, Fabienne, Lafarge, Xavier, Redl, Heinz, Fenelon, Mathilde, Fricain, Jean-Christophe, Di Pietro, Roberta, Ledouble, Charlotte, Gualdi, Thomas, Parmentier, Anne-Laure, Louvrier, Aurélien, Gindraux, Florelle
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9355383/
https://www.ncbi.nlm.nih.gov/pubmed/35935507
http://dx.doi.org/10.3389/fbioe.2022.936074
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author Odet, Stéphane
Meyer, Christophe
Gaudet, Camille
Weber, Elise
Quenot, Julie
Derruau, Stéphane
Laurence, Sebastien
Bompy, Lisa
Girodon, Marine
Chatelain, Brice
Mauprivez, Cédric
Brenet, Esteban
Kerdjoudj, Halima
Zwetyenga, Narcisse
Marchetti, Philippe
Hatzfeld, Anne-Sophie
Toubeau, David
Pouthier, Fabienne
Lafarge, Xavier
Redl, Heinz
Fenelon, Mathilde
Fricain, Jean-Christophe
Di Pietro, Roberta
Ledouble, Charlotte
Gualdi, Thomas
Parmentier, Anne-Laure
Louvrier, Aurélien
Gindraux, Florelle
author_facet Odet, Stéphane
Meyer, Christophe
Gaudet, Camille
Weber, Elise
Quenot, Julie
Derruau, Stéphane
Laurence, Sebastien
Bompy, Lisa
Girodon, Marine
Chatelain, Brice
Mauprivez, Cédric
Brenet, Esteban
Kerdjoudj, Halima
Zwetyenga, Narcisse
Marchetti, Philippe
Hatzfeld, Anne-Sophie
Toubeau, David
Pouthier, Fabienne
Lafarge, Xavier
Redl, Heinz
Fenelon, Mathilde
Fricain, Jean-Christophe
Di Pietro, Roberta
Ledouble, Charlotte
Gualdi, Thomas
Parmentier, Anne-Laure
Louvrier, Aurélien
Gindraux, Florelle
author_sort Odet, Stéphane
collection PubMed
description Medication-related osteonecrosis of the jaw (MRONJ) is a complication of certain pharmacological treatments such as bisphosphonates, denosumab, and angiogenesis inhibitors. There are currently no guidelines on its management, particularly in advanced stages. The human amniotic membrane (hAM) has low immunogenicity and exerts anti-inflammatory, antifibrotic, antimicrobial, antiviral, and analgesic effects. It is a source of stem cells and growth factors promoting tissue regeneration. hAM acts as an anatomical barrier with suitable mechanical properties (permeability, stability, elasticity, flexibility, and resorbability) to prevent the proliferation of fibrous tissue and promote early neovascularization at the surgical site. In oral surgery, hAM stimulates healing and facilitates the proliferation and differentiation of epithelial cells in the oral mucosa and therefore its regeneration. We proposed using cryopreserved hAM to eight patients suffering from cancer (11 lesions) with stage 2–3 MRONJ on a compassionate use basis. A collagen sponge was added in some cases to facilitate hAM grafting. One or three hAMs were applied and one patient had a reapplication. Three patients had complete closure of the surgical site with proper epithelialization at 2 weeks, and two of them maintained it until the last follow-up. At 1 week after surgery, three patients had partial wound dehiscence with partial healing 3 months later and two patients had complete wound dehiscence. hAM reapplication led to complete healing. All patients remained asymptomatic with excellent immediate significant pain relief, no infections, and a truly positive impact on the patients’ quality of life. No adverse events occurred. At 6 months of follow-up, 80% of lesions had complete or partial wound healing (30 and 50%, respectively), while 62.5% of patients were in stage 3. Radiological evaluations found that 85.7% of patients had stable bone lesions (n = 5) or new bone formation (n = 1). One patient had a worsening MRONJ but remained asymptomatic. One patient did not attend his follow-up radiological examination. For the first time, this prospective pilot study extensively illustrates both the handling and surgical application of hAM in MRONJ, its possible association with a collagen sponge scaffold, its outcome at the site, the application of multiple hAM patches at the same time, and its reapplication.
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spelling pubmed-93553832022-08-06 Tips and Tricks and Clinical Outcome of Cryopreserved Human Amniotic Membrane Application for the Management of Medication-Related Osteonecrosis of the Jaw (MRONJ): A Pilot Study Odet, Stéphane Meyer, Christophe Gaudet, Camille Weber, Elise Quenot, Julie Derruau, Stéphane Laurence, Sebastien Bompy, Lisa Girodon, Marine Chatelain, Brice Mauprivez, Cédric Brenet, Esteban Kerdjoudj, Halima Zwetyenga, Narcisse Marchetti, Philippe Hatzfeld, Anne-Sophie Toubeau, David Pouthier, Fabienne Lafarge, Xavier Redl, Heinz Fenelon, Mathilde Fricain, Jean-Christophe Di Pietro, Roberta Ledouble, Charlotte Gualdi, Thomas Parmentier, Anne-Laure Louvrier, Aurélien Gindraux, Florelle Front Bioeng Biotechnol Bioengineering and Biotechnology Medication-related osteonecrosis of the jaw (MRONJ) is a complication of certain pharmacological treatments such as bisphosphonates, denosumab, and angiogenesis inhibitors. There are currently no guidelines on its management, particularly in advanced stages. The human amniotic membrane (hAM) has low immunogenicity and exerts anti-inflammatory, antifibrotic, antimicrobial, antiviral, and analgesic effects. It is a source of stem cells and growth factors promoting tissue regeneration. hAM acts as an anatomical barrier with suitable mechanical properties (permeability, stability, elasticity, flexibility, and resorbability) to prevent the proliferation of fibrous tissue and promote early neovascularization at the surgical site. In oral surgery, hAM stimulates healing and facilitates the proliferation and differentiation of epithelial cells in the oral mucosa and therefore its regeneration. We proposed using cryopreserved hAM to eight patients suffering from cancer (11 lesions) with stage 2–3 MRONJ on a compassionate use basis. A collagen sponge was added in some cases to facilitate hAM grafting. One or three hAMs were applied and one patient had a reapplication. Three patients had complete closure of the surgical site with proper epithelialization at 2 weeks, and two of them maintained it until the last follow-up. At 1 week after surgery, three patients had partial wound dehiscence with partial healing 3 months later and two patients had complete wound dehiscence. hAM reapplication led to complete healing. All patients remained asymptomatic with excellent immediate significant pain relief, no infections, and a truly positive impact on the patients’ quality of life. No adverse events occurred. At 6 months of follow-up, 80% of lesions had complete or partial wound healing (30 and 50%, respectively), while 62.5% of patients were in stage 3. Radiological evaluations found that 85.7% of patients had stable bone lesions (n = 5) or new bone formation (n = 1). One patient had a worsening MRONJ but remained asymptomatic. One patient did not attend his follow-up radiological examination. For the first time, this prospective pilot study extensively illustrates both the handling and surgical application of hAM in MRONJ, its possible association with a collagen sponge scaffold, its outcome at the site, the application of multiple hAM patches at the same time, and its reapplication. Frontiers Media S.A. 2022-07-22 /pmc/articles/PMC9355383/ /pubmed/35935507 http://dx.doi.org/10.3389/fbioe.2022.936074 Text en Copyright © 2022 Odet, Meyer, Gaudet, Weber, Quenot, Derruau, Laurence, Bompy, Girodon, Chatelain, Mauprivez, Brenet, Kerdjoudj, Zwetyenga, Marchetti, Hatzfeld, Toubeau, Pouthier, Lafarge, Redl, Fenelon, Fricain, Di Pietro, Ledouble, Gualdi, Parmentier, Louvrier and Gindraux. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Bioengineering and Biotechnology
Odet, Stéphane
Meyer, Christophe
Gaudet, Camille
Weber, Elise
Quenot, Julie
Derruau, Stéphane
Laurence, Sebastien
Bompy, Lisa
Girodon, Marine
Chatelain, Brice
Mauprivez, Cédric
Brenet, Esteban
Kerdjoudj, Halima
Zwetyenga, Narcisse
Marchetti, Philippe
Hatzfeld, Anne-Sophie
Toubeau, David
Pouthier, Fabienne
Lafarge, Xavier
Redl, Heinz
Fenelon, Mathilde
Fricain, Jean-Christophe
Di Pietro, Roberta
Ledouble, Charlotte
Gualdi, Thomas
Parmentier, Anne-Laure
Louvrier, Aurélien
Gindraux, Florelle
Tips and Tricks and Clinical Outcome of Cryopreserved Human Amniotic Membrane Application for the Management of Medication-Related Osteonecrosis of the Jaw (MRONJ): A Pilot Study
title Tips and Tricks and Clinical Outcome of Cryopreserved Human Amniotic Membrane Application for the Management of Medication-Related Osteonecrosis of the Jaw (MRONJ): A Pilot Study
title_full Tips and Tricks and Clinical Outcome of Cryopreserved Human Amniotic Membrane Application for the Management of Medication-Related Osteonecrosis of the Jaw (MRONJ): A Pilot Study
title_fullStr Tips and Tricks and Clinical Outcome of Cryopreserved Human Amniotic Membrane Application for the Management of Medication-Related Osteonecrosis of the Jaw (MRONJ): A Pilot Study
title_full_unstemmed Tips and Tricks and Clinical Outcome of Cryopreserved Human Amniotic Membrane Application for the Management of Medication-Related Osteonecrosis of the Jaw (MRONJ): A Pilot Study
title_short Tips and Tricks and Clinical Outcome of Cryopreserved Human Amniotic Membrane Application for the Management of Medication-Related Osteonecrosis of the Jaw (MRONJ): A Pilot Study
title_sort tips and tricks and clinical outcome of cryopreserved human amniotic membrane application for the management of medication-related osteonecrosis of the jaw (mronj): a pilot study
topic Bioengineering and Biotechnology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9355383/
https://www.ncbi.nlm.nih.gov/pubmed/35935507
http://dx.doi.org/10.3389/fbioe.2022.936074
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