Abstract
Аннотация. Медикаментозно-ассоциированный остеонекроз челюсти (МАОНЧ) представляет собой тяжёлое осложнение антирезорбтивной и антиангиогенной терапии, проявляющееся лекарственно-индуцированным поражением костной ткани челюстей при отсутствии лучевого воздействия и метастазов. Непредсказуемость результатов лечения определяет необходимость поиска методов, способных усиливать репарацию тканей. Целью работы явилась ретроспективная оценка эффективности хирургического лечения МАОНЧ с применением и без применения тромбоцитарно-обогащённого фибрина. Проанализированы данные 42 пациентов с остеонекрозом нижней челюсти, лечившихся в 2022–2026 гг., разделённых на две группы по использованию ФОТ. Критерием эффективности служило клиническое заживление. Положительные исходы отмечены примерно в 64% случаев. Использование ФОТ демонстрировало тенденцию к лучшим результатам без достижения статистической значимости, что требует дальнейших исследований.
References
1. Marx, R. E. Osteonecrosis of the jaws caused by oral and intravenous administration of bisphosphonates. History, etiology, prevention and treatment; Quintessence Publishing Co., Inc.: Batavia, NY, USA, 2007; pp. 9-96. [ Google Scholar]
2. Council of the American Dental Association on Scientific Issues. Stomatological treatment of patients receiving oral therapy with bisphosphonates: recommendations of the expert group. J. Am. Dent. Assoc. 2006, 137, 1144-1150. [ Google Scholar ] [ CrossRef ]
3. Kim, D. W.; Jung, J. S.; Park, H. S.; Jung, H. D. Everolimus-associated jaw osteonecrosis: case description. Br. J. Oral Maxillofac. Surg. 2013, 51, e302-e304. [ Google Scholar ] [ CrossRef ] [ PubMed ]
4. 4Ruggiero, S.L.; Dodson, T.B.; Fantasia, J.; Goodday, R.; Aghaloo, T.; Mehrotra, B.; O’Ryan, F.; American Association of Oral and Maxillofacial Surgeons. American Association of Oral and Maxillofacial Surgeons position paper on medication-related osteonecrosis of the jaw-2014 update. J. Oral Maxillofac. Surg. 2014, 72, 1938–1956. [Google Scholar] [CrossRef] [PubMed]
5. Campisi, G.; Mauceri, R.; Bertoldo, F.; Bettini, G.; Biasotto, M.; Colella, G.; Consolo, U.; Di Fede, O.; Favia, G.; Fusco, V.; et al. Medication-Related Osteonecrosis of Jaws (МАОНЧ) Prevention and Diagnosis: Italian Consensus Update 2020. Int. J. Environ. Res. Public Health 2020, 17, 5998. [Google Scholar] [CrossRef]
6. 6Fusco, V.; Campisi, G.; Carcieri, P.; Fagioli, F.; Bertetto, O.; Mignogna, M.D.; Bedogni, A. Osteonecrosis of Jaw Related to Bisphosphonates and Other Drugs—Prevention, Diagnosis, Pharmacovigilance, Treatment: A 2021 Web Event. Oral 2022, 2, 137–147. [Google Scholar] [CrossRef]
7. De Cicco, D.; Boschetti, C.E.; Santagata, M.; Colella, G.; Staglianò, S.; Gaggl, A.; Bottini, G.B.; Vitagliano, R.; D’amato, S. Medication-Related Osteonecrosis of the Jaws: A Comparison of SICMF–SIPMO and AAOMS Guidelines. Diagnostics 2023, 13, 2137. [Google Scholar] [CrossRef]
8. 8Chmielewski, M.; Pilloni, A.; Adamska, P. Application of Advanced Platelet-Rich Fibrin in Oral and Maxillo-Facial Surgery: A Systematic Review. J. Funct. Biomater. 2024, 15, 377. [Google Scholar] [CrossRef]
9. Adamska, P.; Kaczoruk-Wieremczuk, M.; Pylińska-Dąbrowska, D.; Stasiak, M.; Bartmański, M.; Zedler, A.; Studniarek, M. Treatment of Oroantral Communication and Fistulas with the Use of Blood-Derived Platelet-Rich Preparations Rich in Growth Factors: A Systematic Review. Int. J. Mol. Sci. 2024, 25, 11507. [Google Scholar] [CrossRef]
10. Adamska, P.; Pylińska-Dąbrowska, D.; Stasiak, M.; Kaczoruk-Wieremczuk, M.; Kozłowska, E.; Zedler, A.; Studniarek, M. Treatment of Odontogenic Maxillary Sinusitis with the Use of Growth Factors in Advanced Platelet-Rich Fibrin for Immediate Closure of Oro-Antral Communication: A Case Report. Int. J. Mol. Sci. 2024, 25, 4339. [Google Scholar] [CrossRef]
11. Chmielewski, M.; Pilloni, A.; Adamska, P. Advanced Platelet-Rich Fibrin Plus (ФОТ+) as an Additive to Hard Tissue Managing Protocols in Oral Surgery: A Systematic Review. J. Funct. Biomater. 2025, 16, 145. [Google Scholar] [CrossRef] [PubMed]
12. Adamska, P.; Pylińska-Dąbrowska, D.; Stasiak, M.; Sobczak-Zagalska, H.; Jusyk, A.; Zedler, A.; Studniarek, M. Tooth Autotransplantation, Autogenous Dentin Graft, and Growth Factors Application: A Method for Preserving the Alveolar Ridge in Cases of Severe Infraocclusion—A Case Report and Literature Review. J. Clin. Med. 2024, 13, 3902. [Google Scholar] [CrossRef]
13. Lopez-Jornet, P.; Perez, A.S.; Arturo, S.P.; Rui, A.M.; Aurelio, T. Medication-related osteonecrosis of the jaw: Is autologous platelet concentrate application effective for prevention and treatment? A systematic review. J. Craniomaxillofac. Surg. 2016, 44, 1067–1072. [Google Scholar] [CrossRef]
14. Frutuoso, F.; Freitas, F.; Vilares, M.; Francisco, H.; Marques, D.; Caramês, J.; Moreira, A. Medication-Related Osteonecrosis of the Jaw: A Systematic Review of Case Reports and Case Series. Diseases 2024, 12, 205. [Google Scholar] [CrossRef] [PubMed]
15. Kaczmarczyk, T.; Babiuch, K.; Bołtacz-Rzepkowska, E.; Dominiak, M.; Konopka, T.; Lipski, M.; Olczak-Kowalczyk, D.; Szeląg, A.; Szuta, M.; Hryniewicz, W. Rekomendacje Grupy Roboczej Polskiego Towarzystwa Stomatologicznego i Narodowego Programu Ochrony Antybiotyków w Zakresie Stosowania Antybiotyków w Stomatologii; Narodowy Instytut Leków: Warszawa, Poland, 2019. [Google Scholar]
16. Momesso, G.A.C.; Lemos, C.A.A.; Santiago-Júnior, J.F.; Faverani, L.P.; Pellizzer, E.P. Laser surgery in management of medication-related osteonecrosis of the jaws: A meta-analysis. Oral Maxillofac. Surg. 2020, 24, 133–144. [Google Scholar] [CrossRef]
17. Freiberger, J.J. Utility of hyperbaric oxygen in treatment of bisphosphonate-related osteonecrosis of the jaws. Oral Maxillofac. Surg. 2009, 67, 96–106. [Google Scholar] [CrossRef] [PubMed]
18. Nica, D.F.; Riviș, M.; Roi, C.I.; Todea, C.D.; Duma, V.-F.; Sinescu, C. Complementarity of Photo-Biomodulation, Surgical Treatment, and Antibiotherapy for Medication-Related Osteonecrosis of the Jaws (МАОНЧ). Medicina 2021, 57, 145. [Google Scholar] [CrossRef]
19. Ripamonti, C.I.; Cislaghi, E.; Mariani, L.; Maniezzo, M. Efficacy and safety of medical ozone (O(3)) delivered in oil suspension applications for the treatment of osteonecrosis of the jaw in patients with bone metastases treated with bisphosphonates: Preliminary results of a phase I-II study. Oral Oncol. 2011, 47, 185–190. [Google Scholar] [CrossRef]
20. Kwon, Y.-D.; Kim, D.-Y. Role of Teriparatide in Medication-Related Osteonecrosis of the Jaws (МАОНЧ). Dent. J. 2016, 4, 41. [Google Scholar] [CrossRef]
21. Jung, J.; Yoo, H.Y.; Kim, G.T.; Lee, J.W.; Lee, Y.A.; Kim, D.Y.; Kwon, Y.D. Short-term teriparatide and recombinant human bone morphogenetic protein-2 for regenerative approach to medication-related osteonecrosis of the jaw: A preliminary study. J. Bone Miner. Res. 2017, 32, 2445–2452. [Google Scholar] [CrossRef]
22. Colapinto, G.; Goker, F.; Nocini, R.; Albanese, M.; Nocini, P.F.; Sembronio, S.; Argenta, F.; Robiony, M.; Del Fabbro, M. Outcomes of a Pharmacological Protocol with Pentoxifylline and Tocopherol for the Management of Medication-Related Osteonecrosis of the Jaws (МАОНЧ): A Randomized Study on 202 Osteoporosis Patients. J. Clin. Med. 2023, 12, 4662. [Google Scholar] [CrossRef] [PubMed]
23. 24Michalak, F.; Dominiak, M.; Kiryk, J.; Popecki, P.; Kubicki, D.; Matys, J.; Grzech-Leśniak, K. The Influence of Vitamin D Levels and Supplementation on the Treatment of Patients Affected by МАОНЧ. Appl. Sci. 2025, 15, 670. [Google Scholar] [CrossRef]