Platelet-rich fibrin as a treatment option for osteoradionecrosis: A literature review - 09/07/21

Doi : 10.1016/j.jormas.2021.06.005

Philippe Harris ^a, Robert Durand ^b,^c, Matthieu Schmittbuhl ^b,^d,^e,^f,^g, Ryma Kabir ^b,^h,^⁎
^a DMD Candidate, Stomatology Department, Division of Maxillofacial Prosthodontics, Université de Montréal Hospital Center (CHUM), Montreal, Canada
^b Stomatology Department, Division of Maxillofacial Prosthodontics, Université de Montréal Hospital Center (CHUM), Montreal, Canada
^c Associate Professor of Periodontology, Faculty of Dental Medicine, Université de Montréal, Montreal, QC, Canada
^d Department Head, Department of Stomatology, Université de Montréal Hospital Center (CHUM), Montréal, Québec, Canada
^e Service Head, Clinical Oral and Maxillofacial Radiology, Faculty of Dental Medicine, Université de Montréal, Québec, Canada
^f Full Professor Department of Stomatology, Faculty of Dental Medicine, Université de Montréal, Montreal, Quebec, Canada
^g Full Professor Department of Radiology, Radio-oncology and Nuclear Medicine, Faculty of Medicine, Université de Montréal, Québec, Canada
^h Full Professor of Periodontology, Faculty of Dental Medicine, Université de Montréal, Montreal, Quebec, Canada

^⁎Corresponding author at: Faculty of Dental Medicine, Université de Montréal, Pavillon Roger-Gaudry – B-1, 2900, boul. Édouard-Montpetit, Montreal (Quebec) H3T 1J4.Faculty of Dental Medicine, Université de MontréalPavillon Roger-Gaudry – B-1, 2900, boul. Édouard-MontpetitMontreal(Quebec)H3T 1J4

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Highlights

•	The use of PRF to treat ORN was reported in 4 cases a per March 8th, 2020.
•	PRF membranes seemed to yield encouraging results in the treatment of ORN lesions.
•	Further controlled clinical trials are needed in this field.

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Abstract

The aim of this review is to establish the usefulness and effectiveness of using platelet-rich fibrin (PRF) in the treatment of osteoradionecrosis (ORN) lesions. A review of the literature was performed using keywords through the PubMed-Medline and Cochrane Library search engine. Inclusion criteria were: (1) original publication in either the French or the English language, (2) studies conducted in humans, (3) presence of ORN lesions following head and neck radiotherapy (RT), (4) use of PRF or derivates in the treatment of ORN lesions, (5) clinical variables and outcomes mentioned in the study. Overall, four case reports were retained. Two publications were removed from the initial seven results after application of the inclusion criteria. A recent randomised clinical trial was not considered since the group analysed the effectiveness of leukocyte-enriched Plasmas-Rich-Fibrin (LPRF) in preventing ORN, but not in treating it. Therefore, four publications were retained for analysis. Results suggest that using PRF as an adjunct to surgical therapy is beneficial in treating ORN lesions although no controlled studies were found. Therefore, additional controlled clinical studies are warranted to better define the effectiveness and recommendation of this approach.

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Keywords : Head and neck cancer, Platelet-rich fibrin, Osteoradionecrosis, Jaw diseases, Radiotherapy, Radiation therapy

Mots-clés : Abbreviations: PRF, LPRF, PRGF, TGF-β, EGF, VEGF, FGF, IGF-1, HGF, ORN, PAOO, Gy, cGy, MRONJ, RT, IMRT, EBRT