Treatment of Medication-Related Osteonecrosis at Dental Implants Utilizing CO2 (9.3 μm) Laser and Sticky Bone: A Case Series
Scott Froum, Stephen Kelleher, Paras Ahmad, Georgios E Romanos and Nathan E Estrin*
ABSTRACT
Introduction: Medication-related osteonecrosis of the jaw (MRONJ) is a significant challenge for clinicians with limited treatment options. In this case series, a CO2 laser (9.3μm) was utilized in conjunction with platelet-rich fibrin (PRF) mixed with allograft to create sticky Bone.
Materials & Methods: Four consecutive patients with MRONJ at implant sites were treated at a private practice setting. The necrotic bone was removed, and the sites were irradiated with a CO2 laser and ethelylenediaminetetraacetate (EDTA). Platelet-rich fibrin (PRF) mixed with BioOss Collagen particulate to create sticky bone to graft in the defect sites and secured with a solid-PRF membrane. Herbal-based mouthrinses in place of chlorehexidine was utilized as a post-surgical rinse. Follow-up time for the cases ranged from 6 months to 7 years.
Results: All patients healed uneventfully without any post-operative complications. In one case, a new implant was placed without any post-operative complications with a 2-year follow-up.
Conclusion: This case series demonstrates successful outcomes of treating MRONJ at implant sites utilizing CO2 laser to decontaminate the implant surface and sticky bone for regenerative therapy. Additional controlled clinical studies are necessary to validate this technique.
