Treatment of avascular osteonecrosis of the mandible in cancer patients with a history of bisphosphonate therapy by combining bone resection and autologous platelet-rich plasma:: Report of 3 cases

Clinical studies have documented considerable number of cases related to the avascular osteonecrosis of the jaws that remains a relatively rare oral complication from the use of bisphosphonates. Treatment of avascular osteonecrosis of the jaws involves a variety of therapies that include antibiotics, 0.12% chlorhexidine mouthwash, sequestrectomy, surgical resection of the necrotic bone, and hyperbaric oxygen therapy. Basic and clinical studies have the efficacy of various cellular mediators in healing bone defects. Dental surgeries seem to be causative factors in the development of avascular nonhealing osteonecrosis. This oral complication may also occur spontaneously and, when it does, involves frequently the posterior lingual bone cortical of the mandible. The management of avascular osteonecrosis of the mandible in the study combined the biomechanical effect of necrotic bone resection with the biologic effect of osteoinductive factors.