The Prophylactic Use of A-PRF in Conjunction with Dental Alveolar Surgery to Minimize the Risk of MRONJ

Abstract

Background/Introduction: Medication-related osteonecrosis of the jaw (MRONJ) is a severe complication associated with anti-resorptive and anti-angiogenic medications, often triggered by dental extractions. It leads to significant morbidity, including pain, infection, and impaired oral function. Preventive strategies remain limited, and treatments are challenging. Advanced platelet-rich fibrin (A-PRF), an autologous blood derivative, has shown promise in enhancing bone regeneration, soft tissue healing, and angiogenesis, potentially reducing MRONJ risk. Objective(s): This study evaluates A-PRF's effectiveness in minimizing MRONJ risk by promoting bone and soft tissue healing in high-risk patients undergoing dental alveolar surgery. Material(s) and Method(s): A prospective observational study was conducted involving eight high-risk MRONJ patients undergoing dental extractions. A-PRF membranes, prepared from autologous blood, were applied to extraction sites following atraumatic extractions with mucosal closure. Patients were assessed clinically and radiographically at six weeks and six months postoperatively. Result(s): At six weeks, patients reported minimal pain, with full mucosal coverage and no evidence of infection or inflammation. By six months, radiographic evaluation confirmed good bone regeneration and sustained mucosal integrity. Conclusion(s): MRONJ treatment is challenging, highlighting the importance of prevention. This study demonstrates A-PRF as an effective adjunctive therapy to reduce MRONJ risk. Further multicenter studies are needed to establish standardized protocols and validate their efficacy.Copyright © 2025