Treatment strategy by Platelet-rich fibrin and establishment of the new evaluation method using PET for MRONJ

2019 Fiscal Year Final Research Report

• Project/Area Number: 17K17229
• Research Category: Grant-in-Aid for Young Scientists (B)
• Allocation Type: Multi-year Fund
• Research Field: Surgical dentistry
• Research Institution: Hokkaido University
• Principal Investigator: ASAKA TAKUYA 北海道大学, 歯学研究院, 助教 (80637265)
• Project Period (FY): 2017-04-01 – 2020-03-31
• Keywords: ARONJ

Outline of Final Research Achievements

In recent years, various treatment study for the anti-resorptive agents-related osteonecrosis of the jaw (ARONJ) is carried out. We examined a surgical management for ARONJ using Platelet-rich fibrin, but it was not approved by the Act on Securing Safety of Regenerative Medicine.
The occurrence of ARONJ in our department was higher than previous reports. We changed the policy not to take a drug holiday before teeth extraction and there is no evidence that it is effective to prevent the onset of ARONJ by taking a drug holiday. The cure rate of ARONJ caused by osteoporosis was higher than ARONJ due to a malignant tumor and the surgical management for ARONJ was better cured than conservative therapy. In the comparison by FDG-PET, ARONJ showed a high accumulation compared to other osteomyelitis of jaw and increased activity of inflammation was shown.

Free Research Field

口腔外科

Academic Significance and Societal Importance of the Research Achievements

創傷治癒促進効果のある多血小板フィブリンによるARONJの新規治療法の確立を目指したが、再生医療等の法の影響にて実施困難な状況にある。少なくとも経口骨吸収抑制薬使用患者の抜歯時には多血小板フィブリンによる治癒遅延防止効果が確認されているので、今後は大規模な予算確保の上での研究を検討している。
また、これまでARONJの骨髄炎としての活動性を他の骨髄炎と比較した報告はなかったが、FDG-PETを用いた本研究により他の骨髄炎と比較して活動性が高いことが示された。炎症活動の亢進などが背景に考えられるが、今後はより詳細な検討を進める予定である。