Protocolo clínico de fibrina rica en plaquetas y leucocitos (L-PRF) para tratamiento de pacientes con osteonecrosis medicamentosa (ONM)

Introduction: LPRF is a combination of platelet and leukocyte-rich fibrin obtained from the patient's blood. Objective: presentation of a case of MRONJ treated using the L-PRF technique Clinical case: 78-year-old woman attends the clinic of the Master's Degree in Oral Medicine, Oral Surgery and Implantology presenting a stage III drug osteonecrosis in the anterosuperior sector associated with previous extractions. The patient presents a personal history of rheumatoid arthritis and osteoporosis previous treatment with Risendronate and Denosumab and currently with corticosteroids and vitamin D. Results: Sequestrectomy of the bone fragment (2.7 x 1.5 cm) was performed under antibiotic coverage by inserting LPRF into the surgical bed (4 plugs and 4 membranes) and first closed with non-resorbable monofilament. The L-PRF was obtained using the Choukroun et al 2001 technique using the IntraSpin system® (Intralock, Florida). A complete healing of the area was observed at the same time, without bone exposure and with no symptomatology, remain stable to this day. Conclusions: The use of L-PRF in patients may be an effective alternative in the surgical treatment of MRONJ.