Objective: This study aimed to investigate the preventive effects of the platelet-rich plasma (PRP)/Bio-Oss granules composite on medication-related osteonecrosis of the jaw (MRONJ).
Material and methods: An MRONJ rat model was established by intraperitoneal injections of zoledronic acid (0.1 mg/kg/dose) thrice a week for 12 weeks. At 4 weeks post-injection, 18 bisphosphonates (BPs)-treated rats underwent bone defect preparations at mandibular molar extraction sites and were then randomly divided into 3 groups (n = 6). In the model control group, the bone defect sites were unfilled. In the Bio-Oss granules group and the composite group, the bone defect sites were filled with Bio-Oss granules and PRP/Bio-Oss granules composites, respectively. Euthanasia was performed at 8 weeks post-surgery. Macroscopic observation, Micro-CT, and histological analysis were performed to analyze bone exposure rate, bone mineral density (BMD), bone volume fraction (BV/TV), and percentage of empty osteocyte lacunae at bone defect sites.
Results: The bone exposure rate in the model control group, Bio-Oss granules group, and composite group was 83.33 %, 66.67 %, and 0 %, respectively. The composite group demonstrated superior mucosal healing, higher BMD, BV/TV, and a lower percentage of empty osteocyte lacunae compared with the other 2 groups (P < 0.001).
Conclusion: Applying Bio-Oss granules alone cannot halt the progression of MRONJ, whereas PRP/Bio-Oss granules composite was effective in preventing MRONJ in BPs-treated rats.
Clinical relevance: The PRP/Bio-Oss granules composite may serve as a potential treatment option for both MRONJ prevention and management of established cases with extensive osteonecrosis.
Keywords: Bisphosphonates; Dental bone and soft-tissue defects; Osteonecrosis; Wound healing.
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