APPLICATION OF AUTOLOGOUS PLASMA IN THE TREATMENT OF MEDICATION RELATED OSTEONECROSIS OF THE JAW

Subject. Drug-associated jaw osteonecrosis is a serious complication that can occur in patients receiving bisphosphonate therapy for bone metastases in malignant neoplasms. The studies are due to the widespread use of bisphosphonates in patients with proven bone metastases, with myeloma, and malignant neoplasms of various locations. Due to the toxic effects of bisphosphonates on soft tissues, the healing process is sluggish, often with a relapse. The task of finding optimal methods of stimulating local regenerative processes is urgent, since the use of general-action drugs can provoke continued growth of the primary tumor. The aim of the study was to develop a method for treating patients with a diagnosis of “drug-associated jaw osteonecrosis” using autologous plasma, which will further reduce the number of relapses and increase the effectiveness of treatment. Methodology. Patients with a diagnosis of “medically associated jaw osteonecrosis” underwent sequestrectomy with boundaries determined by perfusion by laser Doppler flowmetry, an APRF clot was placed on the bottom of the bone wound, and autologous plasma was injected into the wound edges in the postoperative period. Results. The result of applying this technique in the early postoperative period was a partial discrepancy of the edges of the wound, but the absence of sections of the exposed bone in the wound. After 6–8 weeks, we observed complete healing of the postoperative wound. The number of relapses was reduced from 16 to 3 (by 57.56 %). Conclusions. The use of autologous plasma in the treatment of drug-associated osteonecrosis is the most optimal way to stimulate local regenerative processes in the absence of the possibility of using general-action drugs.