Case reports of medication-related osteonecrosis of the jaw (MRONJ) treated with uncultured stromal vascular fraction and L-PRF

C Bouland; N Meuleman; J Widelec; K Keiani-Mothlagh; C Voisin; L Lagneaux; P Philippart

doi:10.1016/j.jormas.2020.05.024

Case reports of medication-related osteonecrosis of the jaw (MRONJ) treated with uncultured stromal vascular fraction and L-PRF

J Stomatol Oral Maxillofac Surg. 2021 Apr;122(2):212-218. doi: 10.1016/j.jormas.2020.05.024. Epub 2020 Jun 12.

Authors

C Bouland¹, N Meuleman², J Widelec³, K Keiani-Mothlagh⁴, C Voisin⁵, L Lagneaux⁶, P Philippart⁷

Affiliations

¹ Medicine faculty, université Libre de Bruxelles (ULB), 808, route de Lennik, 1070 Brussels, Belgium; Laboratory of clinical cell therapy (LCCT), campus Erasme, bâtiment de transfusion (Level +1), Jules-Bordet institute, université Libre de Bruxelles (ULB), 808, Route de Lennik, 1070 Brussels, Belgium; Stomatology and maxillofacial surgery department, CHU de Saint-Pierre, 322, rue Haute, 1000 Brussels, Belgium. Electronic address: cbouland@ulb.ac.be.
² Laboratory of clinical cell therapy (LCCT), campus Erasme, bâtiment de transfusion (Level +1), Jules-Bordet institute, université Libre de Bruxelles (ULB), 808, Route de Lennik, 1070 Brussels, Belgium; Hematology department, Jules-Bordet institute, université Libre de Bruxelles (ULB), 121, boulevard de Waterloo, 1000 Brussels, Belgium.
³ Radiology department, hôpitaux IRIS SUD, site Molière, 142, Rue Marconi, 1190 Brussels, Belgium.
⁴ Stomatology and maxillofacial surgery department, hôpitaux IRIS SUD, site Bracops, 79, Rue Docteur-Huet, 1070 Brussels, Belgium.
⁵ Stomatology and maxillofacial surgery department, hôpitaux IRIS SUD, site Bracops, 79, Rue Docteur-Huet, 1070 Brussels, Belgium; Private practice maxillofacia clos du parnasse Local 3F, 1050 Brussels, Belgium.
⁶ Laboratory of clinical cell therapy (LCCT), campus Erasme, bâtiment de transfusion (Level +1), Jules-Bordet institute, université Libre de Bruxelles (ULB), 808, Route de Lennik, 1070 Brussels, Belgium.
⁷ Medicine faculty, université Libre de Bruxelles (ULB), 808, route de Lennik, 1070 Brussels, Belgium; Radiology department, hôpitaux IRIS SUD, site Molière, 142, Rue Marconi, 1190 Brussels, Belgium.

PMID: 32540361
DOI: 10.1016/j.jormas.2020.05.024

Abstract

Medication-related osteonecrosis of the jaw (MRONJ) is a challenging affection, considering the absence of a "Gold Standard" treatment. Cell therapy and tissue engineering, using adipose-tissue stromal vascular fraction (SVF) containing mesenchymal stromal cells (MSC) and endothelial progenitor cells (EPC); and a scaffold with healing properties, l-platelet-rich fibrin (L-PRF), could be a therapeutic option. Two cases of MRONJ were treated by tissue engineering. The patients presented respectively a stage-II and a stage-III MRONJ. The protocol consists of SVF injection in the L-PRF applied on the cleaned bone. Patients are followed clinically and by medical imaging (MI) for 18 months. The buccal mucosa was closed within a month. No recurrence was observed during the follow-up. The MI highlighted bone formation. MSC and EPC presence, in the SVF, were confirmed by immunophenotyping. We report the preliminary results of MRONJ patients successfully treated with the association of autologous fresh L-PRF-SVF.

Keywords: Bone regeneration; L-platelet-rich fibrin; Medication-related osteonecrosis of the jaw; Stromal vascular fraction; Tissue engineering.

Publication types

Case Reports

MeSH terms

Adipose Tissue
Bisphosphonate-Associated Osteonecrosis of the Jaw* / diagnosis
Bisphosphonate-Associated Osteonecrosis of the Jaw* / therapy
Humans
Mesenchymal Stem Cells*
Platelet-Rich Fibrin*
Wound Healing