Cell therapy in bisphosphonate-related osteonecrosis of the jaw

J Craniofac Surg. 2013 May;24(3):e226-8. doi: 10.1097/SCS.0b013e3182869968.

Abstract

Objective: Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is a clinical condition found in patients who have received intravenous or oral bisphosphonate therapy for various diseases related to bone. This report describes a novel treatment of BRONJ using autologous bone marrow stem cells, platelet-rich plasma, beta tricalcium phosphate, and demineralized bone matrix.

Study design: We report a 71-year-old woman with history of multiple myeloma treated with intravenous zoledronic acid during 4 years. After a tooth extraction, the patient presented with a painful BRONJ lesion with no healing wound and cortical bone exposure. The patient was surgically managed with a standardized protocol of autologous stem cell therapy combining bone marrow harvest, cell concentration procedures, and intraoral surgery.

Results: CT scan performed 6 months later showed improvement of bone and concentric ossification. Cellular therapy might be considered a new strategy to heal BRONJ lesions.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Autografts / transplantation*
  • Biocompatible Materials / therapeutic use
  • Bisphosphonate-Associated Osteonecrosis of the Jaw / surgery*
  • Bone Density Conservation Agents / administration & dosage
  • Bone Marrow Transplantation / methods*
  • Bone Matrix / transplantation
  • Bone Regeneration / physiology
  • Bone Substitutes / therapeutic use
  • Calcium Phosphates / therapeutic use
  • Debridement
  • Diphosphonates / administration & dosage
  • Female
  • Follow-Up Studies
  • Humans
  • Imidazoles / administration & dosage
  • Injections, Intravenous
  • Mandibular Diseases / surgery*
  • Multiple Myeloma / drug therapy
  • Platelet-Rich Plasma / physiology
  • Stem Cell Transplantation / methods*
  • Zoledronic Acid

Substances

  • Biocompatible Materials
  • Bone Density Conservation Agents
  • Bone Substitutes
  • Calcium Phosphates
  • Diphosphonates
  • Imidazoles
  • beta-tricalcium phosphate
  • Zoledronic Acid