GD558 - Preclinical assessment of leukocyte and platelet-rich fibrin for inhibition of mandibular osteonecrosis-GD558

GD558 - Article

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This preclinical rat study tested whether leukocyte- and platelet-rich fibrin (L-PRF) could prevent medication-related osteonecrosis of the jaw (MRONJ) caused by bisphosphonates. Forty-two male rats were assigned to receive sodium alendronate, zoledronic acid, or saline control for 8 weeks before mandibular first molar extraction. After extraction, the sockets were surgically enlarged; one side of each animal’s jaw was filled with L-PRF and the opposite side was left untreated. Drug or control treatment continued for 7 or 28 days after surgery.<br /><br />Repair of the sockets was assessed using microcomputed tomography and histologic analysis. The study found no statistically significant differences in bone volume density between treated and untreated sockets, either within or between groups. In both the alendronate and zoledronic acid groups, histology showed areas of nonvital bone with empty osteocytic lacunae, amorphous material, and inflammatory infiltrate, indicating osteonecrosis. These changes occurred regardless of whether L-PRF was present.<br /><br />Although there was a slight trend toward less necrosis when L-PRF was used, it did not prevent MRONJ. The authors conclude that prolonged exposure to either bisphosphonate interfered with healing of the surgical alveoli, and L-PRF was not effective as a preventive measure in this model. The findings support concern that bisphosphonates can impair post-extraction bone repair, while suggesting that L-PRF alone may be insufficient to counteract this effect.

Keywords

leukocyte-rich fibrin

platelet-rich fibrin

MRONJ

bisphosphonates

alendronate

zoledronic acid

rat study

mandibular extraction

osteonecrosis

bone healing